Using Minimally Invasive Tissue Sampling and Determination of Cause of Death to Establish Etiologies of Community Respiratory Deaths Among Zambian Infants and Children.

In low-to-middle-income countries, acute lower respiratory infection (ALRI) remains the leading infectious cause of death among infants and children under 5 years old. Case-control studies based on upper respiratory sampling have informed current understandings of ALRI etiologies; in contrast, minimally invasive tissue sampling (MITS) offers a method of directly interrogating lower respiratory tract pathogens to establish etiologic distributions. This study performed in the postmortem setting used MITS and a Determination of Cause of Death (DeCoDe) panel to elucidate the causes of fatal pneumonia in the community in Lusaka, Zambia.

Addressing the re-emergence and resurgence of vaccine-preventable diseases in Africa: A health equity perspective.

Vaccination is one of the greatest public health achievements of the 20th century, with a tremendous impact in the prevention and control of diseases. However, the recent reemergence of vaccine-preventable diseases calls for a need to evaluate current vaccination practices and disparities in vaccination between high-income countries and low-and-middle-income countries. There are massive deficits in vaccine availability and coverage in resource-constrained settings.

Community perceived barriers to uptake of health services among men at Sedibeng district in South Africa.

Background: This qualitative study aimed to investigate the barriers that hinder men's utilisation of healthcare services in the Sedibeng district of South Africa.

Methods: The study was conducted using flyers with questions posted on the Best Health Solutions' Facebook page for two weeks. A convenience sampling method was used and a total of 104 comments were collected from 64 respondents.

Exploring the Role of Community Involvement in Reducing the Burden of Schistosomiasis and Other Neglected Tropical Diseases in Malawi: Where are We in the Fight Against Neglected Tropical Diseases?

Schistosomiasis has been endemic in Malawi since 1947. Despite the longevity of endemicity of the disease, it still maintains a high burden in Malawi. This could be attributed to insufficient coverage of preventive and therapeutic mass drug administration (MDA) which mainly targets school-aged children, leaving out adults who also bear a high burden of the disease.

The Transformative Impact of Community-Led Monitoring in the South African Health System: A Comprehensive Analysis.

Community-led monitoring (CLM) is an emerging approach that empowers local communities to actively participate in data collection and decision-making processes within the health system. The research aimed to explore stakeholder perceptions of CLM data and establish a CLM Data Value Chain, covering data collection and its impact. Qualitative data were collected from stakeholders engaged in health programs in South Africa.

Using mortuary and burial data to place COVID-19 in Lusaka, Zambia within a global context.

Reported COVID-19 cases and associated mortality remain low in many sub-Saharan countries relative to global averages, but true impact is difficult to estimate given limitations around surveillance and mortality registration. In Lusaka, Zambia, burial registration and SARS-CoV-2 prevalence data during 2020 allow estimation of excess mortality and transmission. Relative to pre-pandemic patterns, we estimate age-dependent mortality increases, totalling 3212 excess deaths (95% CrI: 2104-4591), representing an 18.

Facilitators and Barriers to the Sustainability of eHealth Solutions in Low- and Middle-Income Countries: Descriptive Exploratory Study.

Background: Despite the widely anticipated benefits of eHealth technologies in enhancing health care service delivery, the sustainable usage of eHealth in transitional countries remains low. There is limited evidence supporting the low sustainable adoption of eHealth in low- and middle-income countries.

Objective: The aim of this study was to explore the facilitators and barriers to the sustainable use of eHealth solutions in low- and middle-income nations.

The early-stage comprehensive costs of routine PrEP implementation and scale-up in Zambia.

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention option, but cost-effectiveness is sensitive to implementation and program costs. Studies indicate that, in addition to direct delivery cost, PrEP provision requires substantial demand creation and client support to encourage PrEP initiation and persistence. We estimated the cost of providing PrEP in Zambia through different PrEP delivery models.

Co-movement between Covid-19 and G20 stock market returns: A time and frequency analysis.

In our study, we employ DCC-GARCH and Wavelet coherence analysis to examine the co-movement between global covid-19 indicators (cases, recoveries and deaths) and stock returns of main equity markets in G20 countries using daily data spanning between February 2, 2020 and August 28, 2021. Our empirical results show that the co-movement between COVID-19 and G20 stock returns has been switching between negative and positive correlations across the entire time window. The wavelet coherence analysis further reveal that negative (positive) co-movements predominantly exist as lower (higher frequencies) for cases and deaths and are more mixed for recoveries.

Rapid assessment of the civil registration and vital statistics performance of health facilities in the five districts of Zambia: A cross-sectional study.

Background: Civil registration and vital statistics (CRVS) are essential administrative tools for accurate statistical data on vital events. However, civil registration coverage is particularly poor in low- and middle-income countries. Currently, CRVS are attracting global attention, as their improvement is considered a priority.

Role of quinone reductases in extracellular redox cycling in lichenized ascomycetes.

Our previous work showed that many lichenized Ascomycetes can generate hydroxyl radicals using quinone-based extracellular redox cycling. During cycling, hydroquinones must be formed and subsequently regenerated from quinones using a quinone reductase (QR). However, we also showed that no simple correlation exists between QR activity and rates of hydroxyl radical formation.

Multimonth dispensing of up to 6 months of antiretroviral therapy in Malawi and Zambia (INTERVAL): a cluster-randomised, non-blinded, non-inferiority trial.

Background: Facility-based, multimonth dispensing of antiretroviral therapy (ART) for HIV could reduce burdens on patients and providers and improve retention in care. We assessed whether 6-monthly ART dispensing was non-inferior to standard of care and 3-monthly ART dispensing.

Methods: We did a pragmatic, cluster-randomised, unblinded, non-inferiority trial (INTERVAL) at 30 health facilities in Malawi and Zambia.

Community-based delivery of HIV treatment in Zambia: costs and outcomes.

Objective: The aim is to determine the total annual cost per patient treated and total cost per patient retained on antiretroviral therapy in Zambia in conventional care in facilities and across community-based differentiated service delivery (DSD) models.

Design: Economic evaluation was conducted using retrospective electronic record review.Twenty healthcare facilities (13 with DSD models and 7 as comparison sites) in six of Zambia's 10 provinces were considered.

A novel multidentate pyridyl ligand: A turn-on fluorescent chemosensor for Hg and its potential application in real sample analysis.

A novel pyridyl-based ligand with multiple binding sites was developed as potential turn on fluorescent probe for mercuric ion. In comparison with other transition metal ions, the ligand displayed a significant optical selectivity and sensitivity for Hg in aqueous solution with a remarkable fluorescence enhancement. The obtained spectroscopic response was related to the inhibition of the photo-chemical mechanism known as photo-induced electron transfer (PET) in the ligand and CN isomerization by Hg binding.

Impact of WHO guidelines on trends in HIV testing and ART initiation among children living with HIV in Zambia.

Background: About 13 years since the introduction of antiretroviral therapy (ART) for children living with HIV (CLHIV) in Zambia, HIV/AIDS testing and treatment guidelines for children have evolved over the years with limited documentation of long-term trends in the numbers testing HIV positive and initiating ART. We examined trends in HIV testing and ART initiation in Zambia.

Methods: We conducted a retrospective cohort study using routinely collected patient level data from 496 health facilities across Zambia.

Provider experiences with three- and six-month antiretroviral therapy dispensing for stable clients in Zambia.

Multi-month dispensing of antiretroviral therapy (ART) has been taken to scale in many settings in sub-Saharan Africa with the benefits of improved client satisfaction and decreased client costs. Six-month ART dispensing may further increase these benefits; however, data are lacking. Within a cluster-randomized trial of three- versus six-month dispensing in Malawi and Zambia, we performed a sub-study to explore Zambian provider experiences with multi-month dispensing.

Novel metric for evaluating pre-exposure prophylaxis programme effectiveness in real-world settings.

Although large-scale provision of HIV pre-exposure prophylaxis (PrEP) is gaining momentum, no systematic method to evaluate or compare the effectiveness of different scale-up strategies in real-world settings exists. To date, estimating the effectiveness of PrEP has relied on clinical trials or mathematical models. We propose a novel and pragmatic metric to evaluate and compare programme effectiveness using routine implementation data.

Eligibility for differentiated models of HIV treatment service delivery: an estimate from Malawi and Zambia.

Background: Little is known about the proportion of HIV-positive clients on antiretroviral therapy (ART) who meet stability criteria for differentiated service delivery (DSD) models. We report the proportion of ART clients meeting stability criteria as part of screening for a randomized trial of multimonth dispensing in Malawi and Zambia.

Methods: For a DSD trial now underway, we screened HIV-positive clients aged at least 18 years presenting for HIV treatment in 30 adult ART clinics in Malawi and Zambia to determine eligibility for DSD.

Monitoring viral load for the last mile: what will it cost?

Introduction: Routine viral load testing is the WHO-recommended method for monitoring HIV-infected patients on ART, and many countries are rapidly scaling up testing capacity at centralized laboratories. Providing testing access to the most remote populations and facilities (the "last mile") is especially challenging. Using a geospatial optimization model, we estimated the incremental costs of accessing the most remote 20% of patients in Zambia by expanding the transportation network required to bring blood samples from ART clinics to centralized laboratories and return results to clinics.

Optimizing viral load testing access for the last mile: Geospatial cost model for point of care instrument placement.

Introduction: Viral load (VL) monitoring programs have been scaled up rapidly, but are now facing the challenge of providing access to the most remote facilities (the "last mile"). For the hardest-to-reach facilities in Zambia, we compared the cost of placing point of care (POC) viral load instruments at or near facilities to the cost of an expanded sample transportation network (STN) to deliver samples to centralized laboratories.

Methods: We extended a previously described geospatial model for Zambia that first optimized a STN for centralized laboratories for 90% of estimated viral load volumes.

Genome of the African cassava whitefly Bemisia tabaci and distribution and genetic diversity of cassava-colonizing whiteflies in Africa.

The whitefy Bemisia tabaci, a species complex consisting of many morphologically indistinguishable species divided into distinct clades, is one of the most globally important agricultural pests and plant virus vectors. Cassava-colonizing B. tabaci transmits viruses that cause cassava mosaic disease (CMD) and cassava brown streak disease (CBSD).

Impact of a biomedical research project on the human capital development of emerging researchers.

Various evaluative studies have been carried out to obtain the views of multiple stakeholders involved in community-based biomedical research projects. However, rarely have the viewpoints of postgraduate students and junior faculty involved in such initiatives been explored. Thus, the aim of this study was to examine the views of postgraduate students and junior faculty at a rural-based university on the effect of a longitudinal biomedical research project on their acquisition of relevant skills.

Impact of a borderless sample transport network for scaling up viral load monitoring: results of a geospatial optimization model for Zambia.

Introduction: The World Health Organization recommends viral load (VL) monitoring at six and twelve months and then annually after initiating antiretroviral treatment for HIV. In many African countries, expansion of VL testing has been slow due to a lack of efficient blood sample transportation networks (STN). To assist Zambia in scaling up testing capacity, we modelled an optimal STN to minimize the cost of a national VL STN.

Returning HIV-1 viral load results to participant-selected health facilities in national Population-based HIV Impact Assessment (PHIA) household surveys in three sub-Saharan African Countries, 2015 to 2016.

Introduction: Logistical complexities of returning laboratory test results to participants have precluded most population-based HIV surveys conducted in sub-Saharan Africa from doing so. For HIV positive participants, this presents a missed opportunity for engagement into clinical care and improvement in health outcomes. The Population-based HIV Impact Assessment (PHIA) surveys, which measure HIV incidence and the prevalence of viral load (VL) suppression in selected African countries, are returning VL results to health facilities specified by each HIV positive participant within eight weeks of collection.