Community-based active-case finding for tuberculosis: navigating a complex minefield.

Community-based active case finding (ACF) for tuberculosis (TB) involves an offer of screening to populations at risk of TB, oftentimes with additional health promotion, community engagement and health service strengthening. Recently updated World Health Organization TB screening guidelines conditionally recommend expanded offer of ACF for communities where the prevalence of undiagnosed pulmonary TB is greater than 0.5% among adults, or with other structural risk factors for TB.

Exploring the Use of Ambientally Stored Methylene Diphosphonate Radiopharmaceutical Aliquots in Solving Challenging Situations in Developing Countries.

 The primary aim was to evaluate the prolonged quality characteristics of methyl diphosphonate (MDP) aliquots during ambient storage over a specified duration. This study further investigated potential additives that could enhance the stability of MDP aliquots stored under such conditions.  This was a laboratory-based experimental study conducted at the University Teaching Adult Hospital in Lusaka, Zambia.

Determining household out of pocket payments, incidence of catastrophic expenditures and impoverishment among patients with malaria in Zambia's path towards Universal Health Coverage.

Background: The World Health Organisation (WHO) estimates that about 3.2 billion people which is nearly half of the world's population are at risk of malaria. Annually about 216 million cases and 445,000 deaths of malaria occur globally.

Asymptomatic carriage of intestinal protists is common in children in Lusaka Province, Zambia.

Background: PCR-based screenings on the presence of diarrhoea-causing intestinal protist species are limited in Zambia, resulting in inaccurate current prevalence and epidemiological data. Sensitive PCR-based methods are particularly well suited for detecting subclinical infections in apparently healthy carriers.

Methodology: In this prospective cross-sectional study, we investigated the occurrence of the most common intestinal protists in an apparently healthy paediatric population (5-18 years) in Lusaka Province, Zambia.

Ecology meets reproductive medicine in HIV prevention: the case for geography-informed approaches for bacterial vaginosis in Africa.

Purpose Of Review: Women in Africa bear the burden of the HIV epidemic, which has been associated with the high prevalence of bacterial vaginosis (BV) in the region. However, little progress has been made in finding an effective cure for BV. Drawing on advances in microbiome-directed therapies for gastrointestinal disorders, similar live-biotherapeutic based approaches for BV treatment are being evaluated.

Therapeutic interventions targeting enteropathy in severe acute malnutrition modulate systemic and vascular inflammation and epithelial regeneration.

Background: Severe acute malnutrition (SAM) is the most life-threatening form of undernutrition, and children hospitalised with complications have unacceptably high mortality. Complicated SAM is a multisystem disease characterised pathophysiologically by muscle wasting, systemic inflammation, metabolic dysfunction, and malnutrition enteropathy including epithelial barrier dysfunction. There is a clear need for novel interventions to address the underlying pathogenic perturbations of complicated SAM.

Leptospira seroprevalence and associated risk factors among slaughterhouse workers in Western Bahr El Ghazal State, South Sudan.

Background: Leptospirosis is a neglected re-emerging and occupational zoonotic disease worldwide. In Africa, contact with livestock is postulated as a potential source of environmental contamination and a source of human Leptospira exposure, though pathways remain unknown. Recently, we confirmed Leptospira exposure and shedding among slaughtered cattle in Western Bahr El Ghazal.

The World Health Organization Access, Watch, and Reserve classification of antibiotics: an awareness survey among pharmacy professionals in a sub-Saharan country, Zambia.

Background: Antimicrobial stewardship programs are very essential in addressing the problem of drug-resistant infections. The WHO Access, Watch, and Reserve (AWaRe) classification of antibiotics is essential in monitoring the rational use of antibiotics. Therefore, this study evaluated the awareness of the WHO AWaRe classification of antibiotics among pharmacy professionals in Zambia.

Inequality in modern contraceptive use and unmet need for contraception among women of reproductive age in Zambia. A trend and decomposition analysis 2007-2018.

Background: Access to contraception can be a transformational intervention towards advancement of education, health, and freedom of choice. Countries have committed to improving access to contraception enshrined in the sustainable development goals (SDGs), indicator 3.7.

Caring for children with SAM: Intersectional stories of shame, blame and stigmatisation in Zimbabwe, Zambia and Kenya.

This paper draws from qualitative research undertaken with the mothers and primary caregivers of children aged under 5 years old and in recovery from severe acute malnutrition (SAM), as well as other community members, across three study sites in Kenya, Zambia, and Zimbabwe. The paper highlights how nutrition-related stigma is constructed and enacted in complex ways, by multiple actors and across diverse settings. Adopting an intersectional approach, the paper identifies how stigma emerges at the intersections of social identity, especially age, gender, and associated beliefs about women's, and especially young women's, assumed (in)capacity to care.

High recent PrEP adherence with point-of-care urine tenofovir testing and adherence counselling among young African women: results from the INSIGHT cohort.

Introduction: Adolescent girls and young women (AGYW) account for two-thirds of new HIV infections in Africa. African AGYW have had high uptake of oral HIV pre-exposure prophylaxis (PrEP) but low adherence, which might be improved by point-of-care adherence monitoring with tailored counselling.

Methods: From August 2022 to July 2023, we conducted a PrEP demonstration project with sexually active AGYW ages 16-30 years from 20 sites in South Africa, Eswatini, Kenya, Malawi, Uganda and Zambia.

Bacteriology testing and antimicrobial resistance detection capacity of national tiered laboratory networks in sub-Saharan Africa: an analysis from 14 countries.

Background: Accurate detection of antimicrobial resistance (AMR) depends on adequate laboratory capacity. We aimed to document key weaknesses hindering AMR detection at various tiers of laboratory networks in 14 countries in sub-Saharan Africa, and analyse their significance in AMR surveillance and policies.

Methods: In this analysis, we obtained retrospective data on AMR and antimicrobial consumption from 14 countries participating in the Mapping Antimicrobial Resistance and Antimicrobial Use Partnership between May 1, 2019, and June 30, 2020.

At risk but not adequately included: People with disabilities' experience of COVID-19 in Zambia.

Background: COVID-19 had an impact on all sections of society, including people with disabilities.

Objectives: The authors aimed to explore the needs and experiences of people with disabilities in Zambia during the COVID-19 pandemic.

Method: In this hermeneutic phenomenological study, we used a semi-structured interview guide to collect data from a purposive and snowball sample of 40 people with disabilities and their caregivers.

Effect of a multicomponent, person-centred care intervention on client experience and HIV treatment outcomes in Zambia: a stepped-wedge, cluster-randomised trial.

Background: Recipients of health services value not only convenience but also respectful, kind, and helpful providers. To date, research to improve person-centred HIV treatment has focused on making services easier to access (eg, differentiated service delivery) rather than the interpersonal experience of care. We developed and evaluated a person-centred care (PCC) intervention targeting practices of health-care workers.

Diagnosis and management of status epilepticus: improving the status quo.

Status epilepticus is a common neurological emergency that is characterised by prolonged or recurrent seizures without recovery between episodes and associated with substantial morbidity and mortality. Prompt recognition and targeted therapy can reduce the risk of complications and death associated with status epilepticus, thereby improving outcomes. The most recent International League Against Epilepsy definition considers two important timepoints in status epilepticus: first, when the seizure does not self-terminate; and second, when the seizure can have long-term consequences, including neuronal injury.

The coping strategies employed by individuals with chronic low back pain: secondary qualitative analysis of data from diverse adult populations in two sub-Saharan African countries.

Introduction: The use and influence of coping mechanisms vary across cultures and evaluation methods. Limited research exists on coping mechanisms for non-specific chronic low back pain (CLBP) in African societies. This secondary qualitative study explored adaptive and maladaptive coping strategies used by adults with CLBP in Nigerian and Zambian communities.

Exploring key challenges for healthcare providers and stakeholders in delivering adolescent sexual and reproductive health services and information during the COVID-19 pandemic in Malawi, Zambia and Zimbabwe: a qualitative study.

Introduction: This study aimed to explore the direct and indirect influences of COVID-19-related restrictions on adolescents and young people's (AYP's) sexual and reproductive health and rights (SRHR) in Malawi, Zambia, and Zimbabwe, with a focus on teenage pregnancy and access to and utilization of HIV testing and counselling services.

Methods: Thirty-four purposively sampled interviews that comprised of selected representatives of organizations involved in activities aimed at addressing adolescent sexual and reproductive health and rights (ASRHR), teenage pregnancies, and HIV testing were conducted in Malawi, Zambia and Zimbabwe. In Zambia, the study conducted an additional four group discussions with adolescents and young people.

Dynamics of the blood plasma proteome during hyperacute HIV-1 infection.

The complex dynamics of protein expression in plasma during hyperacute HIV-1 infection and its relation to acute retroviral syndrome, viral control, and disease progression are largely unknown. Here, we quantify 1293 blood plasma proteins from 157 longitudinally linked plasma samples collected before, during, and after hyperacute HIV-1 infection of 54 participants from four sub-Saharan African countries. Six distinct longitudinal expression profiles are identified, of which four demonstrate a consistent decrease in protein levels following HIV-1 infection.

An in-depth analysis of factors influencing small-scale cattle farmers' participation in livestock markets in Western Province of Zambia: navigating challenges and barriers.

Introductions: The low participation of small-scale farmers in livestock markets in sub-Saharan Africa, including Zambia, is a major inhibitor to private sector investment in the livestock subsector. Despite the immense potential of the livestock industry to bolster the economic development of countries in this region, several socioeconomic, environmental, and cultural factors contribute to this hindrance.

Methods: This study was conducted in the Western Province of Zambia and adopted a qualitative research approach to understand the challenges and barriers affecting livestock markets among smallholder cattle farmers.

Antibiotic Dispensing Practices Among Community Retail Pharmacies and Registered Drugstores: Results from a Simulated Client Study in Lilongwe, Malawi.

Introduction: Antimicrobial resistance (AMR) is largely driven by the inappropriate use of antibiotics. This has been attributed to the non-prescription sale of antibiotics in retail drug outlets. Despite the rising number of retail drug outlets in Malawi, the practice of drug dispensing in private pharmacies has not been evaluated.