Effect of coinfections on neurocognitive functioning among people with clade C HIV infection in Zambia.

Despite the fact that many coinfections in people with HIV (PWH) are treatable or suppressible, they may still impact neurocognitive (NC) functioning. Here, we aim to evaluate the presence of latent/treated coinfections and their association with NC functioning in a cohort of PWH in Zambia. We carried out a cross-sectional, nested study involving 151 PWH with viral suppression, and a normative sample of 324 adults without HIV.

Cognitive Impairment in Zambians With HIV Infection and Pulmonary Tuberculosis.

Background: HIV infection may result in neurocognitive deficits, but the effects of pulmonary tuberculosis (TB+), a common comorbid condition in HIV infection, on cognition in HIV infections are unknown. Accordingly, we examined the effects of TB+, on neurocognitive functioning in HIV-infected (HIV+) Zambian adults.

Setting: All participants were drawn from HIV clinics in and around Lusaka, the capital of Zambia.

Perceived acceptability of progesterone to prevent preterm births and low birth weight among HIV-infected and HIV-uninfected Zambian pregnant women.

Introduction: Intramuscular and vaginal progesterone are recommended for prevention of preterm labor (PTL) in women with risk factors. Studies are emerging to indicate that HIV-infected women on combination antiretroviral therapy (cART) are at risk of PTL and low birth weight (LBW), and may benefit from supplemental progesterone. This study aims to determine the perceived acceptability of various modes of progesterone supplementation to prevent PTL and LBW in HIV-infected and HIV-uninfected women.

Developing a Family Medicine Postgraduate Training Program in Zambia.

The last decade has seen a number of educational programs in family medicine begin throughout the African region as many countries have recognized that family medicine offers an efficient way to meet the growing health demands of their country. Zambia's health situation is similar to many countries in sub-Saharan Africa by having a wide array of compelling health demands and a health sector with a limited capacity to meaningfully respond. This paper describes the efforts to begin Zambia's first post-graduate training program for family medicine.

Efficacy of WHO recommendation for continued breastfeeding and maternal cART for prevention of perinatal and postnatal HIV transmission in Zambia.

Introduction: To prevent mother-to-child transmission (MTCT) of HIV in developing countries, new World Health Organization (WHO) guidelines recommend maternal combination antiretroviral therapy (cART) during pregnancy, throughout breastfeeding for 1 year and then cessation of breastfeeding (COB). The efficacy of this approach during the first six months of exclusive breastfeeding has been demonstrated, but the efficacy of this approach beyond six months is not well documented.

Methods: A prospective observational cohort study of 279 HIV-positive mothers was started on zidovudine/3TC and lopinavir/ritonavir tablets between 14 and 30 weeks gestation and continued indefinitely thereafter.

Cognitive and language outcomes in HIV-uninfected infants exposed to combined antiretroviral therapy in utero and through extended breast-feeding.

Objective: To determine whether there is a higher risk for cognitive or language delay among HIV-exposed uninfected (HEU) children exposed to cART (zidovudine/lamivudine/lopinavir/ritonavir) in utero and through 1 year of breast-feeding (World health Organization Option B+), compared with the control children born to HIV-uninfected mothers.

Design: This is a double cohort study from Lusaka, Zambia.

Methods: HEU (n = 97) and control (n = 103) children aged 15-36 months were assessed on their early nonverbal problem-solving and language skills using the standardized Capute Scales.

Knowledge base and caretaker-child communication about HIV in peri-urban schoolchildren of Lusaka, Zambia.

Peri-urban communities, which face health risks of both urban and rural environments, have grown extensively with recent global urbanization. These communities' combination of multiple HIV risk factors with the lack of a formalized sexual education system sets the stage for high-risk behavior in peri-urban youth. We conducted a cross-sectional survey of children (ages 5-17, N=331) and accompanying caretakers in peri-urban Lusaka, Zambia, using both closed- and open-ended questions to investigate HIV knowledge and communication.

Schistosomiasis haematobium prevalence and risk factors in a school-age population of peri-urban Lusaka, Zambia.

Given association of the parasite Schistosoma haematobium with coastal and rural/agricultural populations, there is little documentation to date of infection patterns in today's rapidly urbanizing non-coastal regions. We conducted an observational study of 5-17-year-old school children (N = 1583) in peri-urban compounds of Lusaka, Zambia. Demographic information, medical history, physical examination findings and urinalysis results were recorded.

Mapping an HIV/STD prevention curriculum for Zambian in-school settings.

HIV/AIDS poses grave risk to human development in sub-Saharan Africa. Evidence-based interventions that are rooted in local culture could help efforts to prevent threats to human development from HIV/AIDS. We used concept mapping (Concept System, 2006 ) to construct the components and content of a locally developed HIV/AIDS curriculum for use by secondary schools in Lusaka, Zambia.

Mental health and disclosure of HIV status in Zambian adolescents with HIV infection: implications for peer-support programs.

Objectives: To examine emotional and behavioural difficulties in HIV positive Zambian adolescents and to determine the relationship between disclosure of HIV status and mental health.

Design: A cross-sectional survey.

Methods: Participants were 127 HIV positive adolescents aged 11 to 15 years recruited through clinics in the Lusaka region.

Congenital trypanosomiasis.

The last successfully treated case of congenital trypanosomiasis in Zambia was in October 1978, with detailed analysis of immunoglobulins, illustrating the waning of blood and serum levels of IgA, IgG, and IgM during treatment, up to 99 days after treatment. Twenty-five years later, we report on a case of congenital trypanosomiasis. The disease is now rare and can be missed or dismissed as retroviral disease, particularly in adults.