Medicine and Health Sciences Commons^™

Co-Infection And Co-Localization Of Kaposi Sarcoma-Associated Herpesvirus And Epstein-Barr Virus In Hiv-Associated Kaposi Sarcoma: A Case Report, Peter Julius, Guobin Guobin, Stepfanie Siyumbwa, Jane Musumali, For Yue Tso, Owen Ngalamika, Trevor Kaile, Fred Maate, Phyllis Moonga, John T. West, Peter Angeletti, Charles Wood

Nebraska Center for Virology: Faculty Publications

Kaposi sarcoma (KS), a multifocal vascular neoplasm frequently observed in HIVpositive individuals, primarily affects the skin, mucous membranes, visceral organs, and lymph nodes. KS is associated primarily with Kaposi sarcomaassociated herpesvirus (KSHV) infection. In this case report, we present a rare occurrence of co-infection and co-localization of KSHV and Epstein-Barr virus (EBV) in KS arising from the conjunctiva, which, to our knowledge, has not been reported previously. Immunohistochemistry (IHC), DNA polymerase chain reaction (PCR), and EBV-encoded RNA in situ hybridization (EBER-ISH) were utilized to demonstrate the presence of KSHV and EBV infection in the ocular KS lesion. Nearly all KSHV-positive …

Yes-Associated Protein-1 Overexpression In Ocular Surface Squamous Neoplasia; A Potential Diagnostic Marker And Therapeutic Target, Peter Julius, Stepfanie N. Siyumbwa, Fred Maate, Phyllis Moonga, Guobin Kang, Trevor Kaile, John T. West, Charles Wood, Peter C. Angeletti

School of Graduate Studies Faculty Publications

Yes-associated protein-1 (YAP-1) is a Hippo system transcription factor, which serves as an oncogene in squamous cell carcinoma, and several solid tumors when the Hippo pathway is dysregulated. Yet, the activity of YAP-1 in ocular surface squamous neoplasia (OSSN) has not been determined. Here, we investigate the relationship between YAP-1 overexpression and OSSN. Using a cross-sectional study design, we recruited 227 OSSN patients from the University Teaching Hospitals in Lusaka, Zambia. Immunohistochemistry was used to assess YAP-1 protein overexpression in tumor tissue relative to surrounding benign squamous epithelium. OSSN patient samples (preinvasive, n = 62, 27% and invasive, n = …

Yes-Associated Protein-1 Overexpression In Ocular Surface Squamous Neoplasia; A Potential Diagnostic Marker And Therapeutic Target, Peter Julius, Stepfanie N. Siyumbwa, Fred Maate, Phyllis Moonga, Guobin Kang, Trevor Kaile, John T. T., Charles Wood

Nebraska Center for Virology: Faculty Publications

Yes-associated protein-1 (YAP-1) is a Hippo system transcription factor, which serves as an oncogene in squamous cell carcinoma, and several solid tumors when the Hippo pathway is dysregulated. Yet, the activity of YAP-1 in ocular surface squamous neoplasia (OSSN) has not been determined. Here, we investigate the relationship between YAP-1 overexpression and OSSN. Using a cross-sectional study design, we recruited 227 OSSN patients from the University Teaching Hospitals in Lusaka, Zambia. Immunohistochemistry was used to assess YAP-1 protein overexpression in tumor tissue relative to surrounding benign squamous epithelium. OSSN patient samples (preinvasive, n = 62, 27% and invasive, n = …

Comparison Of Patient Exit Interviews With Unannounced Standardised Patients For Assessing Hiv Service Delivery In Zambia: A Study Nested Within A Cluster Randomised Trial, Kombatende Sikombe, Aaloke Mody, Ingrid Eshun-Wilson, Elvin Geng, Et Al.

2020-Current year OA Pubs

OBJECTIVES: To compare unannounced standardised patient approach (eg, mystery clients) with typical exit interviews for assessing patient experiences in HIV care (eg, unfriendly providers, long waiting times). We hypothesise standardised patients would report more negative experiences than typical exit interviews affected by social desirability bias.

SETTING: Cross-sectional surveys in 16 government-operated HIV primary care clinics in Lusaka, Zambia providing antiretroviral therapy (ART).

PARTICIPANTS: 3526 participants aged ≥18 years receiving ART participated in the exit surveys between August 2019 and November 2021.

INTERVENTION: Systematic sample (every n

OUTCOME MEASURES: We compared patient experience among patients who received brief training prior to …

Cross-Sectional Study To Assess Depression Among Healthcare Workers In Lusaka, Zambia During The Covid-19 Pandemic, Sandra Simbeza, Jacob Mutale, Musunge Mulabe, Lazarus Jere, Chama Bukankala, Kombatende Sikombe, Izukanji Sikazwe, Carolyn Bolton-Moore, Aaloke Mody, Elvin H. Geng, Anjali Sharma, Laura K. Beres, Jake M. Pry

2020-Current year OA Pubs

OBJECTIVES: We sought to assess depression among healthcare workers (HCWs) in the context of COVID-19 in Lusaka Province, Zambia.

DESIGN: This cross-sectional study is nested within a larger study, the Person-Centred Public Health for HIV Treatment in Zambia (PCPH), a cluster-randomised trial to assess HIV care and outcomes.

SETTING: The research was conducted in 24 government-run health facilities from 11 August to 15 October 2020 during the first wave of the COVID-19 pandemic in Lusaka, Zambia.

PARTICIPANTS: We used convenience sampling to recruit HCW participants who were previously enrolled in the PCPH study, had more than 6 months' experience working …

Multilingual Zambia - Language Issues In Primary/Secondary Schools Of The Eastern/Southern Provinces, Kenzie Steiner

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Introduction: Zambia is a multilingual country that uses 8 different languages for instruction including English and 7 other indigenous languages.

Methods: Survey research conducted between May-June 2022 on 6-7th graders within 9 Zambian schools. Classroom observations made and teachers interviewed.

Results: In Eastern and Southern Provinces, Zambian teachers speak an average of 5 languages while students speak an average of 2. Both teachers and students say English remains the most important language followed by first languages.

Conclusion: Continued research on language-in-education policies and impacts on student performance must be conducted if “One Zambia, One Nation” is meant to promote all …

Genetic Variation In Environmental Enteropathy And Stunting In Zambian Children: A Pilot Genome Wide Association Study Using The H3africa Chip, Monica N. Mweetwa, Talin Haritunians, Shishir Dube, Kanta Chandwe, Beatrice Amadi, Kanekwa Zyambo, Ta-Chiang Liu, Dermot Mcgovern, Paul Kelly

2020-Current year OA Pubs

PURPOSE: Stunting is known to be heavily influenced by environmental factors, so the genetic contribution has received little attention. Here we report an exploration of genetic influences in stunted Zambian children with environmental enteropathy.

METHOD: Children with stunting (LAZ < -2) were enrolled and given nutritional therapy. Those that were non-responsive to therapy were designated as cases, and children with good growth (LAZ > -1) from the same community as controls. Blood and stool samples were taken to measure biomarkers of intestinal inflammation, epithelial damage, and microbial translocation. Single nucleotide polymorphism array genotyping was carried out on saliva samples using the H3Africa consortium array.

RESULTS: Genome wide associations were analysed in 117 cases and 41 controls. While no significant associations with stunting were observed at …

Leveraging Health Infrastructure To Optimize Hpv Vaccination For Adolescents In Zambia: Protocol For An Implementation Study, Sam Miti, Thembekile Shato, Comfort Asante, Ana Baumann, Gershom Chongwe, Patricia M. Bobo, Michelle I. Silver, Jean M. Hunleth

2020-Current year OA Pubs

BACKGROUND: Cervical cancer is the leading cause of cancer death in Zambia, where HIV prevalence is also high (11.3%). HIV heightens the risk of developing and dying from cervical cancer. The human papillomavirus (HPV) vaccine can prevent 90% of cervical cancers, and in Zambia is recommended for adolescent girls ages 14-15 years, including those with HIV. Currently they mainly deliver HPV vaccination via school-based campaigns, which may exclude the most vulnerable adolescents-those out-of-school or who irregularly attend. Adolescents living with HIV (ALHIV) are more likely to have these vulnerabilities. Further, school-based campaigns are not tailored to the WHO-recommended HPV vaccination …

Hiv Care Experiences And Health Priorities During The First Wave Of Covid-19: Clients' Perspectives - A Qualitative Study In Lusaka, Zambia, Njekwa Mukamba, Anjali Sharma, Chanda Mwamba, Herbert Nyirenda, Marksman Foloko, Kasapo Lumbo, Katerina Christopoulos, Sandra Simbeza, Kombatende Sikombe, Charles B Holmes, Elvin H Geng, Izukanji Sikazwe, Carolyn Bolton-Moore, Laura K Beres

2020-Current year OA Pubs

BACKGROUND: The novel COVID-19 pandemic threatened to disrupt access to human immunodeficiency (HIV) treatment for persons living with HIV (PLHIV), two-thirds of whom live in sub-Saharan Africa. To inform a health system response supportive of continuity of care, we sought to understand clients' HIV care experiences and health priorities during the first wave of COVID-19 outbreak in Lusaka, Zambia.

METHODS: Leveraging a study cohort of those who completed periodic SMS surveys on HIV care, we purposefully sampled 25 PLHIV after first confirmed COVID-19 case was reported in Zambia on 18

RESULTS: All participants were aware of COVID-19, and HIV care …

Patient Preferences For Strategies To Improve Tuberculosis Diagnostic Services In Zambia, Andrew D Kerkhoff, Lophina Chilukutu, Sarah Nyangu, Mary Kagujje, Kondwelani Mateyo, Nsala Sanjase, Ingrid Eshun-Wilson, Elvin H Geng, Diane V Havlir, Monde Muyoyeta

2020-Current year OA Pubs

Importance: Delayed engagement in tuberculosis (TB) services is associated with ongoing transmission and poor clinical outcomes.

Objective: To assess whether patients with TB have differential preferences for strategies to improve the public health reach of TB diagnostic services.

Design, Setting, and Participants: A cross-sectional study was undertaken in which a discrete choice experiment (DCE) was administered between September 18, 2019, and January 17, 2020, to 401 adults (>18 years of age) with microbiologically confirmed TB in Lusaka, Zambia. The DCE had 7 attributes with 2 to 3 levels per attribute related to TB service enhancements. Latent class analysis was …

Epstein-Barr Virus, But Not Human Papillomavirus, Is Associated With Preinvasive And Invasive Ocular Surface Squamous Neoplasias In Zambian Patients, Peter Julius, Stepfanie N. Siyumbwa, Phyllis Moonga, Fred Maate, Trevor Kaile, Gleb Haynatski, Veenu Minhas, Jazmine Snow, Kerstin Peterson, Patience Gihozo, Sam Streeter, Salan Kaur, Annika Evans, Daniela Gonzalez, Kandali Samwel, Guobin Kang, John T. West

LSU-LCMC Cancer Center Faculty Publications

BACKGROUND: The etiopathogenesis of ocular surface squamous neoplasia (OSSN) is not fully understood. We assessed the frequency of oncogenic viruses in OSSN by immunohistochemistry (IHC) and polymerase chain reaction (PCR) for human papillomavirus (HPV), Epstein-Barr virus (EBV), Merkel cell polyomavirus (MCPyV), Kaposi sarcoma virus, and adenovirus. Cases from Zambia were prospectively enrolled using a cross-sectional study design between November 2017 and March 2020. METHODS: Demographic and clinical data [age, sex, HIV status, antiretroviral therapy (ART) history, CD4 count, plasma viral load] and tumor biopsies were collected from 243 consenting patients. Tumor samples were bisected, and half was used for DNA …

Patient-Reported Reasons For Stopping Care Or Switching Clinics In Zambia: A Multisite, Regionally Representative Estimate Using A Multistage Sampling-Based Approach In Zambia, Izukanji Sikazwe, Ingrid Eshun-Wilson, Kombatende Sikombe, Laura K Beres, Paul Somwe, Aaloke Mody, Sandra Simbeza, Chama Bukankala, David V Glidden, Lloyd B Mulenga, Nancy Padian, Peter Ehrenkranz, Carolyn Bolton-Moore, Charles B Holmes, Elvin H Geng

2020-Current year OA Pubs

BACKGROUND: Understanding patient-reported reasons for lapses of retention in human immunodeficiency virus (HIV) treatment can drive improvements in the care cascade. A systematic assessment of outcomes among a random sample of patients lost to follow-up (LTFU) from 32 clinics in Zambia to understand the reasons for silent transfers and disengagement from care was undertaken.

METHODS: We traced a simple random sample of LTFU patients (>90 days from last scheduled visit) as determined from clinic-based electronic medical records from a probability sample of facilities. Among patients found in person, we solicited reasons for either stopping or switching care and predictors …

Comparing Growth Velocity Of Hiv Exposed And Non-Exposed Infants: An Observational Study Of Infants Enrolled In A Randomized Control Trial In Zambia, Obvious Nchimunya Chilyabanyama, Roma Chilengi, Natasha Makabilo Laban, Masuzyo Chirwa, Michelo Simunyandi, Luiza Miyanda Hatyoka, Innocent Ngaruye, Najeeha Talat Iqbal, Samuel Bosomprah

Department of Paediatrics and Child Health

Background: Impaired growth among infants remains one of the leading nutrition problems globally. In this study, we aimed to compare the growth trajectory rate and evaluate growth trajectory characteristics among children, who are HIV exposed uninfected (HEU) and HIV unexposed uninfected (HUU), under two years in Zambia.
Method: Our study used data from the ROVAS II study (PACTR201804003096919), an open-label randomized control trial of two verses three doses of live, attenuated, oral RotarixTM administered 6 &10 weeks or at 6 &10 weeks plus an additional dose at 9 months of age, conducted at George clinic in Lusaka, Zambia. Anthropometric measurements …

Mothers Without Borders Program Evaluation: Establishing Effective Program Evaluation To Assess Holistic Orphan Care Initiatives In Zambia, Alyssa Baer

Undergraduate Honors Theses

This paper uses an interdisciplinary approach—combining theories and methodologies from the Social Impact and Public Health disciplines—to design an evaluation of Mothers Without Borders’ (MWB) programs in Lusaka, Zambia. Their programs aim to support communities as they care for children in crisis living in their communities—with a focus on communities with large populations of orphaned and vulnerable children (OVC) as a result of the HIV/AIDS epidemic. This paper provides an overview of the orphan crisis, international orphan care standards, and evaluation practices in order to understand and design an effective evaluation plan for the organization. This project aims to provide …

Food Sourcing And The Relationship To Height Of 6th To 7th Graders In Southern Ethiopia And Zambia, Flora Bescansa Luers

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Introduction: Zambia and Ethiopia are Sub-Saharan African countries experiencing high rates of malnutrition and stunting. This study examines food sourcing and its relationship to stunting.

Methods: Anthropometric assessment and food frequency-sourcing interviews were taken for 488 6th-7th graders in Livingstone, Zambia and Hawassa, Ethiopia. Data were analyzed using ANOVA.

Results: Most students sourced food from local markets and home gardens; however Zambian students used a greater variety of sources. Those sourcing from home gardens were significantly taller.

Discussion: Home gardening provides economic and health benefits, as well as food security. A focus on preservation and use …

Project Yes! Youth Engaging For Success: A Randomized Controlled Trial Testing A Peer Mentoring Approach Among Hiv-Positive Adolescents And Young Adults In Ndola, Zambia, Julie Denison, Virginia M. Burke, Sam Miti, Bareng A.S. Nonyane, Christiana Frimpong, Katherine G. Merrill, Elizabeth A. Abrams, Jonathan Kaunda Mwansa

HIV and AIDS

This research addresses the gaps in knowledge about how to best support adolescents and young adults transitioning to HIV self-management in the context of both child-focused and adult-focused HIV care settings. Johns Hopkins University, in partnership with the Arthur Davison Children’s Hospital, implemented this study through the USAID-funded Project SOAR (led by the Population Council).

Mental Health Literacy Among Rural And Urban Young Adults In Zambia, Etta Y. Mwambwa-Johnson

Walden Dissertations and Doctoral Studies

Misconceptions that negatively influence attitudes and beliefs about mental illness are still prevalent in Zambia. Researchers have reported that young adults are the most impacted population for mental disorders in Zambia. Researchers have also highlighted mental health literacy (MHL) as a useful strategy for influencing positive attitudes and beliefs about mental disorders. The purpose of this quantitative cross-sectional study was to investigate the relationship between levels of MHL and attitudes and beliefs about mental illness and health-seeking behaviors of Zambian young adults aged 18 to 24. The study used the health belief theoretical model. A MHL questionnaire was used to …

Profiles Of Hiv Care Disruptions Among Adult Patients Lost To Follow-Up In Zambia: A Latent Class Analysis, Aaloke Mody, Kombatende Sikombe, Laura K. Beres, Sandra Simbeza, Njekwa Mukamba, Ingrid Eshun-Wilson, Sheree Schwartz, Jake Pry, Nancy Padian, Charles B. Holmes, Carolyn Bolton-Moore, Izukanji Sikazwe, Elvin H. Geng

2020-Current year OA Pubs

BACKGROUND: Patients report varied barriers to HIV care across multiple domains, but specific barrier patterns may be driven by underlying, but unobserved, behavioral profiles.

METHODS: We traced a probability sample of patients lost to follow-up (>90 days late) as of July 31, 2015 from 64 clinics in Zambia. Among those found alive, we ascertained patient-reported reasons for care disruptions. We performed latent class analysis to identify patient subgroups with similar patterns of reasons reported and assessed the association between class membership and care status (ie, disengaged versus silently transferred to a new site).

RESULTS: Among 547 patients, we identified …

Longitudinal Care Cascade Outcomes Among People Eligible For Antiretroviral Therapy Who Are Newly Linking To Care In Zambia: A Multistate Analysis, Aaloke Mody, David V Glidden, Ingrid Eshun-Wilson, Kombatende Sikombe, Sandra Simbeza, Njekwa Mukamba, Paul Somwe, Laura K Beres, Jake Pry, Carolyn Bolton-Moore, Nancy Padian, Charles B Holmes, Izukanji Sikazwe, Elvin H Geng

2020-Current year OA Pubs

BACKGROUND: Retention in human immunodeficiency virus (HIV) care is dynamic, with patients frequently transitioning in and out of care. Analytical approaches (eg, survival analyses) commonly used to assess HIV care cascade outcomes fail to capture such transitions and therefore incompletely represent care outcomes over time.

METHODS: We analyzed antiretroviral therapy (ART)-eligible adults newly linking to care at 64 clinics in Zambia between 1 April 2014 and 31 July 2015. We used electronic medical record data and supplemented these with updated care outcomes ascertained by tracing a multistage random sample of patients lost to follow-up (LTFU, >90 days late for last …

Availability And Consumption Of Vitamin A Foods Among Southern Ethiopian And Zambian Primary Students, Trang Vuong

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Purpose: Understand vitamin A food availability in open-air markets (OAM’s), and consumption of those foods by primary school children in southern Ethiopia/Zambia.

Methods: Conducted inventories of all consumable/potable items and interviewed 6-7th grade students about consumption of items with vitamin A.

Results: Students consumed most of the 14 vitamin A foods/items sold in OAM’s. Zambian students ate more liver, pumpkin, squash, watermelon, and wild fruits, while Ethiopian students almost never consumed squash, watermelon or wild fruits.

Conclusions: The availability of Vitamin A foods in Ethiopian and Zambian OAMs are varied; however, Zambian children reportedly eat more vitamin A foods. Nutrition …

How Might Improved Estimates Of Hiv Programme Outcomes Influence Practice? A Formative Study Of Evidence, Dissemination And Response, Njekwa Mukamba, Laura K Beres, Chanda Mwamba, Jeanna Wallenta Law, Stephanie M Topp, Sandra Simbeza, Kombatende Sikombe, Nancy Padian, Charles B Holmes, Elvin H Geng, Izukanji Sikazwe

2020-Current year OA Pubs

BACKGROUND: While HIV programmes have started millions of persons on life-saving antiretroviral therapy in Africa, longitudinal health information systems are frail and, therefore, data about long-term survival is often inaccurate or unknown to HIV programmes. The 'Better Information for Health in Zambia' (BetterInfo) Study - a regional sampling-based survey to assess retention and mortality in HIV programmes in Zambia - found both retention and mortality to be higher than prevailing estimates from national surveillance systems. We sought to understand how Zambian health decision-makers at different health system levels would respond to these new data, with a view to informing research …

A Case Study Of Ovc Case Management Through The Zambia Family (Zamfam) Project—Brief, Population Council

HIV and AIDS

The ZAMFAM program aims to improve the care and resilience of orphans and vulnerable children (OVC) as well as young people living with HIV in Zambia by providing support and protection and by strengthening the capacity of children, families, and the community to better manage the socioeconomic shocks of the HIV/AIDS epidemic. A case study approach was employed to understand actors and perceptions, and to document best practices by the program. This brief summarizes the case study findings. The ZAMFAM program utilized several approaches to improving the well-being of OVC. Services or referrals were provided to beneficiaries through home visitation …

Documenting Lessons From An Integrated Social And Behavior Change Program Linked To Integrated Health Services In Zambia, Breakthrough Research

Reproductive Health

This program brief documents lessons for social and behavior change programmers implementing multi-health, community-based programs with integrated health services. An iterative process by Breakthrough ACTION Zambia, from October 2018 through March 2019, identified four design concepts with strong feasibility and potential for impact and expansion. These four concepts were refined in Breakthrough ACTION Zambia provinces and districts in collaboration with implementing partners and the Ministry of Health Department of Health Promotion, with final intervention design and implementation processes determined in close collaboration with the Ministry.

A Case-Study Of Ovc Case Management Through The Zambia Family (Zamfam) Project, Lyson Phiri, Drosin Mulenga, Nancy Choka, Caila Brander, Nachela Chelwa, Nkomba Kayeyi

HIV and AIDS

Zambia’s HIV prevalence is estimated at 11% among adults aged 15–49 years and 1% among children younger than 15 years. An estimated 10% of Zambia’s population is at high risk of being orphaned or vulnerable due to the HIV epidemic. The Zambia Family (ZAMFAM) project aims to improve the care and resilience of vulnerable populations while supporting HIV epidemic control. ZAMFAM used a case management approach that tracks beneficiaries from identification to graduation. The Population Council conducted a qualitative case study to understand actors and perceptions, and document best practices. Program beneficiaries viewed the ZAMFAM program as having made a …

Reducing Hiv Risk Among Young Women And Their Partners: Highlights From The Dreams Implementation Science Research Portfolio, Population Council

HIV and AIDS

The Population Council, with funding from the Bill & Melinda Gates Foundation and the U.S. Agency for International Development through Project SOAR, led a set of implementation science studies to capture multiple perspectives that reflect the innovative aspects of DREAMS. These mixed-method studies conducted across seven countries (Eswatini, Kenya, Malawi, South Africa, Tanzania, Uganda, and Zambia) provide critical evidence that fill knowledge gaps on how to reduce HIV risk among AGYW and their male partners. This brief presents key findings grouped around four areas of inquiry: 1) HIV vulnerability and risk; 2) social drivers of HIV risk; 3) effects of …

The Role Of Agency In Early And Unwanted Adolescent Pregnancy: A Multi Country Analysis, Katharine Mccarthy

Dissertations and Theses

Purpose. The agency to decide one’s reproductive future is paramount, yet an estimated 75 percent of adolescent girls in the United States (U.S.) and 49 percent of those in low and middle-income countries experience mistimed or unwanted pregnancy. This dissertation characterized empirical representations of agency over the course of adolescence and investigated the relationship between agency and early and unwanted pregnancy and childbearing using data from three countries (India, Zambia and the U.S.).

Methods. Using latent class and latent transition analysis, multi-dimensional profiles of adolescent agency were assessed using data from: (1) a state representative cross-sectional cohort study of adolescents …

Grains, Grasses, And Tubers: Staple Carbohydrates In The Diets Of Middle School Children Of Southern Zambia And Ethiopia, Brianna Juma

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

Purpose: Survey staple carbohydrate availability in local markets, complete anthropometric assessment, and interview primary school children about carbohydrate consumption in Southern Zambia and Ethiopia

Methods: Market inventories, anthropometric assessments, and interviews of 6th and 7th grade students

Results: Ethiopians have a greater diversity of available carbohydrates, have better overall anthropometric values compared to Zambian children, and consume more nutritious and varied carbohydrate types.

Conclusions: Diversity in carbohydrate availability and consumption, as well as more nutritious options, are associated with healthier growth rates among primary school children in Southern regions of Zambia and Ethiopia.

Protein Availability And Consumption, And Stunting Rates, For Primary School Children In The Southern Regions Of Ethiopia And Zambia, Megan Wackel

NUTR/GLST 498b: Global Research Experiences in Nutrition and Health

•Stunting is common in Sub-Sahara Africa, with millions of children who are short in stature also experiencing poor overall health and development, as well as poor school performance (Semba 2016; Semba, et al., 2016). •As many as 39% of children under 5 years of age in Ethiopia’s Sidama Region (formerly SNNPR) can be classified as stunted (CSA & ICF 2016). By comparison, 29% of under 5’s in Zambia’s Southern Province have short height for age (CSA, MOH, & ICF 2018). •Low protein and essential amino acid intake, among populations of 116 countries, has been suggested as the primary cause of …

Evaluating Implementation Effectiveness And Sustainability Of A Maternity Waiting Homes Intervention To Improve Access To Safe Delivery In Rural Zambia: A Mixed-Methods Protocol, Elizabeth G. Henry, Thandiwe Ngoma, Jeanette L. Kaiser, Rachel M. Fong, Taryn Vian, Davidson H. Hamer, Peter C. Rockers, Godfrey Biemba, Nancy A. Scott

Nursing and Health Professions Faculty Research and Publications

Background: In low-income countries such as Zambia, where maternal mortality rates are persistently high, maternity waiting homes (MWHs) represent one potential strategy to improve access to safe delivery, especially for women living in remote areas. The Maternity Homes Access in Zambia project (MAHMAZ) is evaluating the impact of a MWH model on women’s access to safe delivery in rural Zambia. There is a growing need to understand not only the effectiveness of interventions but also the effectiveness of their implementation in order to appropriately interpret outcomes. There is little evidence to guide effective implementation of MWH for both immediate uptake …

Redefining And Revisiting Cost Estimates Of Routine Art Care In Zambia: An Analysis Of Ten Clinics, Austin Tucker, Tannia Tembo, Radhika P Tampi, Jacob Mutale, Mpande Mukumba-Mwenechanya, Anjali Sharma, David W Dowdy, Carolyn B Moore, Elvin Geng, Charles B Holmes, Izukanji Sikazwe, Hojoon Sohn

2020-Current year OA Pubs

INTRODUCTION: Accurate costing is key for programme planning and policy implementation. Since 2011, there have been major changes in eligibility criteria and treatment regimens with price reductions in ART drugs, programmatic changes resulting in clinical task-shifting and decentralization of ART delivery to peripheral health centres making existing evidence on ART care costs in Zambia out-of-date. As decision makers consider further changes in ART service delivery, it is important to understand the current drivers of costs for ART care. This study provides updates on costs of ART services for HIV-positive patients in Zambia.

METHODS: We evaluated costs, assessed from the health …