Exact Expressions for Kullback-Leibler Divergence for Univariate Distributions.

The Kullback-Leibler divergence (KL divergence) is a statistical measure that quantifies the difference between two probability distributions. Specifically, it assesses the amount of information that is lost when one distribution is used to approximate another. This concept is crucial in various fields, including information theory, statistics, and machine learning, as it helps in understanding how well a model represents the underlying data.

Documenting Trends in Malaria Data Reporting Accuracy Using Routine Data Quality Audits in Zambia, 2015-2022.

Since 2015, the Zambia National Malaria Elimination Centre has conducted routine data quality audits in Central, Southern, and Western provinces, but trends in data reporting accuracy have not been examined. Routine data quality audit data collected at health facilities reporting into the monthly health management information system (HMIS) and weekly malaria rapid reporting system (MRRS) were used to measure data reporting accuracy trends from 2015 to 2022 and potential influencing factors using three data elements: outpatient department attendance and rapid diagnostic test (RDT)-tested cases for HMIS and MRRS, total confirmed cases for HMIS only, and RDT-positive cases for MRRS only. Reporting accuracies for HMIS and MRRS data elements and the percentage of facilities reporting with high accuracy (≥85%) improved over this period.

African lineage 1a West Nile virus isolated from crocodiles exhibits low neuroinvasiveness in mice.

West Nile virus (WNV) is a mosquito-borne flavivirus that causes encephalitis in humans and infects crocodiles, resulting in rashes and neurological signs. In Zambia, two distinct lineages of WNV have been detected in neighbouring areas: lineage 2 in mosquitoes and lineage 1a in farmed crocodiles. Considering the risk of direct or vector-mediated WNV transmission from crocodiles to mammals, it is necessary to elucidate the pathogenicity of WNV strains derived from crocodiles.

The pattern of diabetic care and glycemic control among the ambulatory diabetic patients in tertiary care settings in Bangladesh.

Diabetes mellitus is a major public health concern in Bangladesh. The pattern of diabetic care and control of blood sugar among diabetic patients are not well described. We assessed the pattern of diabetic care among ambulatory diabetic patients attending tertiary care hospitals in Bangladesh, and explored the relationship of glycemic control with behavioral and metabolic risks.

Immunochromatographic Lateral Flow Assays to Detect Filovirus Nucleoproteins.

The recent large outbreaks of Ebola virus disease in West Africa and the Democratic Republic of the Congo have highlighted the need for rapid diagnostic tests to control this disease. In this chapter, the development of immunochromatographic lateral flow assays to detect filovirus nucleoproteins is described as an example of designing rapid diagnostic tests.

Editorial: ticks & tick-borne parasites and diseases.

Ticks and tick-borne diseases affect humans, livestock, and wildlife in most regions of the globe. Although there are over 900 tick species globally, only approximately 10% of species are second to mosquitoes as major vectors of human and veterinary diseases. The 17 articles of this themed Special Issue highlight the current research trends associated with newly discovered tick species, concepts of tick evolution, new vaccinology approaches, factors affecting disease transmission, and factors affecting tick ecology and tick-borne disease epidemiology.

Associations between family planning, healthcare access, and female education and vaccination among under-immunized children.

Background: Increasing childhood vaccination, family planning, healthcare access, and women's empowerment are targets of the Sustainable Development Goals (SDG). Barriers to healthcare access impede vaccination; tackling goals holistically could create larger gains than siloed efforts. We studied Nepal, Senegal, and Zambia to test the association between childhood vaccinations and other SDG indicators to identify clustered deprivations.

Urine-Xpert Ultra for the diagnosis of tuberculosis in people living with HIV: a prospective, multicentre, diagnostic accuracy study.

Background: Diagnostic delays for tuberculosis are common, with high resultant mortality. Urine-Xpert Ultra (Cepheid) could improve time to diagnosis of tuberculosis disease and rifampicin resistance. We previously reported on lot-to-lot variation of the Fujifilm SILVAMP TB LAM.

Cost-effectiveness analysis of a prediction model for community-based screening of active tuberculosis.

Background: Active case finding could effectively detect tuberculosis (TB) patients, but it can be costly. Therefore, a feasible, cost-saving, and efficient algorithm for community-based TB screening is needed.

Methods: The study population was based on a previous TB prevalence survey conducted in the Zambia/South Africa Tuberculosis and HIV/AIDS Reduction trial.

Development of a seroepidemiological tool for bat-borne and shrew-borne hantaviruses and its application using samples from Zambia.

Background: Rodent-borne orthohantaviruses are the causative agents of hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. Apart from the classic rodent-borne hantaviruses, numerous species of hantaviruses have been identified in shrews and bats; however, their antigenicity and pathogenicity are unknown. This study focused on developing a serological method to detect antibodies against bat- and shrew-borne hantaviruses.

Contextual factors impacting WHO Framework Convention on Tobacco Control implementation in Africa-a scoping review.

According to the World Health Organization (WHO), tobacco use causes over 8 million deaths annually including 1.3 million due to second-hand exposure. Furthermore, data from the Tobacco Atlas show that the tobacco industry continues to target new markets in the WHO African region, one of two regions where absolute numbers of smokers continue to increase.

Availability and readiness of public health facilities to provide differentiated service delivery models for HIV treatment in Zambia: implications for better treatment outcomes.

Background: There is persistent pressure on countries with a high burden of HIV infection to reach desired targets for HIV treatment outcomes. This has led to moving from the "one-size-fits-all" model to differentiated service delivery (DSD) models, which are meant to be more patient-centered and efficient but without compromising on the quality of patient care. However, for DSD models to be efficient, facilities should have indicators of HIV services available and ready to provide the DSD models.

The role of vitamin D metabolism in regulating bone turnover in adolescents with perinatally-acquired HIV in Southern Africa: a cross-sectional study in Zimbabwe and Zambia.

Vitamin D dysregulation can occur in people living with HIV, disrupting calcium homeostasis, and bone turnover. We aimed to investigate the potential mechanisms by which vitamin D regulates bone turnover in adolescents living with perinatally-acquired HIV (ALWH) in Southern Africa. A pre-planned secondary analysis was performed of baseline data from the vitamin D for adolescents with HIV to reduce musculoskeletal morbidity and immunopathology trial (PACTR20200989766029) which enrolled ALWH (11-19 yr) taking antiretroviral therapy for ≥6 mo, and recorded socio-demographic, clinical and dietary data.

Amplifying youth voices: young people's recommendations for policy and practice to enhance vaccine acceptability.

Background: The COVID-19 pandemic has underscored the need for increased vaccine availability and uptake, with vaccine hesitancy posing a significant barrier, particularly among young adults. Evidence from various countries highlight high levels of hesitancy among young people, necessitating targeted interventions. Engaging young adults as key stakeholders in shaping public health strategies is crucial, as their perspectives can enhance vaccine acceptance.

Health technology assessment to support health benefits package design: a systematic review of economic evaluation evidence in Zambia.

Background: Health technology assessment uses explicit economic evaluation evidence to support health benefits package design. However, the limited availability of technical expertise, data, and methods has restricted the production of economic evaluation evidence in low- and middle-income countries. Zambia has initiated a roadmap to support its policy of reviewing and implementing its national benefits package.

International virtual radiation therapy professional development: Reflections on a twinning collaboration between a low/middle and high income country.

In response to the documented challenges to providing adequate radiotherapy services to its population, the Ethiopian government has embarked on a plan to augment such services. In tandem with the need for the required equipment is the need for qualified staff for its safe operation. Twinning collaborations between low (LIC) and high income countries (HIC) have been proven effective for improving health care services and outcomes.

Assessment of catchment water resources allocation under climate change in Luwombwa sub-catchment, Zambia.

The uncertainty in climate change and high water demand pose pressure on the natural water resources supply. Not only does this require better understanding but also a call for immediate interventions, mitigation and adaptive measures. This study evaluates catchment water resources in the Luwombwa sub-catchment in Zambia through statistical analysis in the downscaling of past, present and future climatic variables from the CMIP6 climatic model.

The performance of a point-of-care test for the diagnosis of Neurocysticercosis in a resource-poor community setting in Zambia - a diagnostic accuracy study.

Background: Neurocysticercosis (NCC) is the main cause of epilepsy in endemic rural communities. NCC diagnosis is difficult due to unavailability and unaffordability of serologic assays and neuroimaging. This study aimed to assess the performance of a cheap, novel lateral-flow point-of-care (TS POC) test for the diagnosis of NCC in a community setting.

Collaborative dynamics and shared motivation: exploring tobacco control policy development in Zambia.

In Zambia, efforts to produce a tobacco control policy have stalled for over a decade, and the country is not yet close to developing one. Limited studies have explored the dynamics in this policy process and how they affect the attainment of policy goals and outcomes. This study explored how collaborative dynamics within tobacco control policy development shaped shared motivation among stakeholders in Zambia.

Habu vipers (Protobothrops flavoviridis) are an overlooked but important reservoir of the zoonotic tick Amblyomma testudinarium (Acari: Ixodidae) in subtropical Asia.

Subtropical Asia has a rich diversity of reptiles and ticks, though the role of reptiles in the sylvatic cycles of medically important ticks in the region is poorly known. Habu vipers (Protobothrops flavoviridis) are widespread and common in the Japanese subtropics but their role as hosts for ticks has not been carefully explored. For 15 months in 2023/24, habu vipers were screened for ticks and were found to be important hosts for immature stages of the tick Amblyomma testudinarium, with a 22 % infestation rate.

Markers of Environmental Enteric Dysfunction are Associated with Poor Growth and Developmental Outcomes among Young Children in Lusaka, Zambia.

Objective: To examine cross-sectional relationships between biomarkers of environmental enteric dysfunction (EED), an acquired subclinical condition of the small intestine, and anthropometric and developmental outcomes among children in Lusaka, Zambia.

Study Design: Serum samples were collected from 240 children aged 27 to 35 months enrolled in a cluster-randomized trial assessing the effects of growth charts and small-quantity lipid-based nutrient supplements on linear growth. Samples were analyzed using the 11-plex Micronutrient and EED Assessment Tool, which incorporates 2 biomarkers of EED, namely intestinal fatty acid-binding protein (I-FABP), a marker of epithelial damage, and soluble CD14 (sCD14), a marker of microbial translocation.

Efficacy of attractive targeted sugar bait stations against malaria in Western Province Zambia: epidemiological findings from a two-arm cluster randomized phase III trial.

Background: Attractive targeted sugar bait (ATSB) stations containing bait (to attract) and ingestion toxicant (to kill) sugar-foraging mosquitoes are hypothesized to reduce malaria transmission by shortening the lifespan of Anopheles vectors.

Methods: A two-arm cluster-randomized controlled trial (cRCT) was conducted in Western Province Zambia. Seventy clusters of 250-350 households were assigned (1:1) by restricted randomization to an intervention arm (ATSB) or control arm (no ATSB) in the context of standard of care vector control (insecticide-treated nets and/or indoor residual spraying).