Publications by authors named "Kasonde Bowa"

Public health initiatives in Zambia encourage the uptake of early infant male circumcision (EIMC) as an HIV prevention strategy. This study assessed EIMC parental decision-making during perinatal care in Lusaka, Zambia, focusing on the influence of sociodemographic factors, family, and friends. A longitudinal pilot perinatal intervention, Like Father Like Son (LFLS), was implemented among 300 couples attending antenatal clinics in four urban community health centers.

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Despite compelling evidence linking voluntary medical male circumcision (VMMC) with 60-70% HIV risk reduction in sub-Saharan Africa, Zambian men have been especially reluctant to undergo VMMC. The Government of Zambia set targets for VMMC uptake and promoted community-level interventions. Spear & Shield (S&S) is an innovative, evidence-based, service program promoting VMMC uptake while ensuring both VMMC supply and demand.

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Our aim was to determine the current trend of endourology in the management of upper urinary tract calculi in Africa reference centres. We conducted an online multiple-choice questionnaire survey involving 46 centres from 27 countries using a structured well-designed Google Form (®) questionnaire. The questionnaires were distributed to the head of service through their emails.

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Article Synopsis
  • Voluntary Medical Male Circumcision (VMMC) and Early-Infant Medical Circumcision (EIMC) are key strategies in HIV prevention, especially in high-risk areas like Zambia, where a significant number of male infants could benefit.
  • The "Like Father, Like Son" (LFLS) pilot study involved 702 couples and demonstrated that combining EIMC and VMMC services led to a notable increase in EIMC rates, achieving 35% compared to previous rates of 11%.
  • The study suggests that involving fathers in the circumcision process could enhance bonding and increase uptake of circumcision for both infants and older sons, pointing towards a family-focused approach for future HIV prevention efforts.
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Male circumcision is a protective HIV prevention strategy. However, uncircumcised Zambian men are reluctant to undergo voluntary medical male circumcision (VMMC). Tailored interventions are necessary to stimulate the uptake of early infant male circumcision (EIMC) and VMMC in Zambia.

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Article Synopsis
  • The meta-analysis investigates the effects of varicocele repair on semen parameters in infertile males, combining data from diverse studies without language restrictions.
  • A total of 351 studies were analyzed, revealing significant improvements in several semen parameters post-repair, including semen volume, sperm concentration, total sperm count, motility, and morphology, while sperm vitality showed no improvement.
  • This research is the largest of its kind and highlights the benefits of varicocele repair for male infertility, contributing valuable insights for clinical practice.
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  • The study investigates global practices for managing sperm DNA fragmentation (SDF) in infertile men, highlighting its impact on fertility and assisted reproductive technology (ART).
  • A survey collecting data from 436 reproductive experts across 55 countries revealed a common recommendation for lifestyle changes and antioxidants, with varying durations for treatment and differing management approaches for specific infertility cases.
  • The findings indicate a lack of uniformity in practices, emphasizing the need for standardized guidelines and expert consensus for treating men with elevated SDF.
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  • The study explores global practices for sperm DNA fragmentation (SDF) testing in infertile men, following its inclusion in the WHO laboratory manual.
  • A survey conducted among 436 infertility clinicians across 55 countries reveals varied testing practices, with many testing SDF in cases of unexplained infertility, recurrent pregnancy loss, and among smokers.
  • The findings highlight the need for clearer professional guidelines on SDF testing, given the diversity in current practices and the potential benefits for certain patient populations.
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Despite increasing interest in Early-Infant and Early-Adolescent Medical Circumcision (EIMC and EAMC, respectively) in Zambia, parental willingness to have their sons undergo the procedure has not been explored. This study describes Zambian parents' perspectives on EIMC and EAMC. A total of N = 600 men and women (n = 300 couples) were recruited.

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Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes.

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Several large-scale clinical trials have conclusively demonstrated that voluntary medical male circumcision (VMMC) could provide a 50%-70% reduction in HIV acquisition, but willingness to undergo VMMC has been lowest in Zambia compared to other countries in eastern and southern Africa. This manuscript describes training for "task-shifting" among local healthcare workers at Community Health Centers (CHCs) applying state of the art strategies (e.g.

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Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition.

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Article Synopsis
  • * Differentiating between asthenozoospermia (low sperm motility) and necrozoospermia (low sperm vitality) is crucial for diagnosing and treating infertility, as their causes can be local or systemic.
  • * A global survey was conducted to assess current practices regarding sperm vitality testing and necrozoospermia management, aiming to create a standard approach for diagnosis and treatment in clinical settings.
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Background: Voluntary Medical Male Circumcision (VMMC) is a key intervention in HIV/AIDS. Improving VMMC program uptake in Zambia requires careful monitoring of adverse events (AE) to inform program quality and safety. We investigate the prevalence of VMMC AE and their associated factors among adult males in Ndola, Copperbelt Province, Zambia.

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Introduction: The International Prostate Symptom Score (IPSS) is a useful tool approved by the World Health Organisation and the American Urological Association to measure the severity of lower urinary tract symptoms (LUTS). Although commonly used in urological practice, the IPSS has faced many challenges in terms of its usage in developing countries. In our setting, most patients presenting with this condition are elderly patients with a low literacy level.

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The objective of the research was to study the correlation of internal organ weights with body weight and length in normal adult Zambians. The study involved 114 (83 males and 31 females) forensic autopsies from Ndola Teaching Hospital done over a period of 12 months. The cases included autopsies of unnatural deaths including road traffic accidents and homicide.

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Urethral stricture disease is the commonest cause of morbidity in urology practice in sub-Saharan Africa. In contrast, prostate disease is commonly cited as the leading cause of urological disease in most urology practices in developed countries. In Africa, the aetiology of urethral stricture disease is compounded by a high prevalence of sexually transmitted infections (STIs), increasing levels of urethral trauma and over-stretched urological services.

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Introduction: Zambia is facing a chronic shortage of health care workers. The paper aimed at understanding how the Medical Education Partnership Initiative (MEPI) program facilitated strengthening and expanding of the national capacity and quality of medical education as well as processes for retaining faculty in Zambia.

Methods: Data generated through documentary review, key informant interviews and observations were analyzed using a thematic approach.

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Objective: Medical device use is currently approved for males without preputial or major penile scrotal abnormalities for voluntary medical male circumcision (VMMC). We determined the prevalence of preputial abnormalities at a busy VMMC centre in Soweto, South Africa.

Methods: This was a cross-sectional record review at a high-volume VMMC centre in South Africa.

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With the recent massive scale-up of access to antiretroviral therapy (ART) in resource-limited countries, HIV has become a chronic disease with new challenges. There is mounting evidence of an increased burden of renal and genitourinary diseases among HIV-infected persons caused by direct HIV viral effects and/or indirectly through the development of opportunistic infections, ART medication-related toxicities, and other noncommunicable diseases (NCDs). We review the epidemiology of HIV-associated renal and urogenital diseases, including interactions with kidney-related NCDs such as hypertension, diabetes mellitus, and cardiovascular disease.

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Zambia is facing a crisis in its human resources for health, with deficits in the number and skill mix of health workers. The University of Zambia School of Medicine (UNZA SOM) was the only medical school in the country for decades, but recently it was joined by three new medical schools--two private and one public. In addition to expanding medical education, the government has also approved several allied health programs, including pharmacy, physiotherapy, biomedical sciences, and environmental health.

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