Journal of Preventive and Rehabilitative Medicine

Editorial-Forecasting the anthrax outbreak dynamics in Zambia

Brian Chanda Chiluba — 2023-11-08

Anthrax, a highly infectious disease with deep historical roots believed to have originated in ancient Egypt and Mesopotamia, continues to pose a significant public health and agricultural threat in Zambia. This zoonotic disease, primarily affecting herbivores, including domestic livestock and wildlife, also affects humans, with three primary forms: cutaneous, gastrointestinal, and inhalation anthrax. Zambia has experienced recurring anthrax outbreaks, especially in rural or agricultural areas, where transmission occurs through activities such as handling infected animal carcasses and consuming contaminated meat. To address this ongoing challenge, the Zambian government has implemented measures like surveillance, livestock vaccination, proper carcass disposal, and public awareness campaigns. The recurrence of anthrax outbreaks in Zambia is influenced by seasonal variations and interactions between Bacillus anthracis, grazing hosts, and the transmission of anthrax through necrophagous flies. An understanding of the environmental dynamics of anthrax, including spore persistence and soil interactions, is crucial for effective management. In recent months, Zambia has faced another anthrax outbreak in the Western Province, affecting both human and animal populations. Health authorities have urged livestock vaccination and advised against consuming potentially contaminated meat. Proactive measures, including mass vaccination campaigns and movement restrictions for cattle, are being employed to control this larger-scale outbreak. Mathematical models like the SIR-model can provide valuable tools for forecasting and understanding anthrax outbreaks. Projections for various Zambian provinces suggest varying outbreak patterns, highlighting the importance of tailored intervention strategies. Anthrax outbreaks in Zambia are a multifaceted challenge that requires comprehensive efforts in disease control, surveillance, and public awareness.

Mismanagement of pesticides among smallholder farmers: A growing concern

Kweleka Mwanza — 2023-11-08

Africa's agricultural sector faces a significant threat from pests and diseases, leading to increased reliance on chemical pesticides among smallholder farmers. Recent surveys across Sub Saharan Africa reveal high pesticide use, with up to 87% reported in Rwanda. However, the indiscriminate use and improper disposal of pesticides raise concerns about long-term effects on human health and the environment. Epidemiological and molecular research underscores the risks of pesticide exposure, contributing to respiratory complications, reproductive disorders, birth defects, and environmental disruptions. Smallholder farmers, frequently exposed without proper protection, suffer from various health symptoms, such as headaches, skin irritations, and digestive issues. Globally, pesticide poisoning accounts for nearly 300,000 deaths annually. Efforts to address this issue require a multi-pronged approach. Firstly, investment in agricultural extension services is essential to provide training on sustainable farming practices that reduce pesticide dependence. Secondly, policymakers must promote safer alternatives to highly hazardous pesticides, including bio-pesticides, botanical extracts, and integrated pest management techniques. Finally, strengthening regulatory frameworks and enforcement is crucial to control pesticide sale, distribution, and ensure safe usage. The misuse of chemical pesticides poses a serious threat to human health, the environment, and agriculture productivity. Addressing these challenges requires immediate action to ensure the well-being of smallholder farmers, protect human health, and safeguard the environment.

Impact of the COVID-19 pandemic on people living with disabilities: A review

Ethel N Malambo — 2023-11-08

Introduction: The global COVID-19 pandemic had a profound impact on people worldwide, with some countries experiencing more severe consequences than others. Vulnerable populations, such as individuals living with disabilities, faced pre-existing disparities and inequities, making it crucial to examine the specific effects of the pandemic on this group. This review aims to analyze articles discussing the effects of the COVID-19 pandemic on people living with various disabilities. Methods: A comprehensive search for articles was conducted on Google Scholar using keywords such as "COVID-19 and disability," "COVID-19 and ADHD," "COVID-19 and blindness," and "COVID-19 and developmental disabilities." A total of thirteen (13) relevant articles were carefully selected and reviewed. Results: People living with disabilities were significantly impacted by the COVID-19 pandemic. The effects faced by individuals with disabilities varied, depending on the specific type of disability they had. This underscores the importance of recognizing and addressing the unique challenges faced by each disability group during the pandemic. Conclusion: The COVID-19 pandemic exacerbated the difficulties faced by individuals living with disabilities. It is crucial for governing bodies, policymakers, and decision-makers to consider the needs and experiences of people with disabilities, taking into account the added challenges they encountered during the pandemic. By incorporating disability-inclusive policies and initiatives, we can work towards a more equitable and supportive society for all, especially during times of crisis.

HIV and cardiovascular disease: A review of awareness and control of risk factors

Mweene Haamaundu — 2023-11-08

Background: People living with HIV (PWLH) face an elevated risk of cardiovascular disease (CVD), posing a significant public health challenge. Understanding the intricate mechanisms behind this heightened risk is imperative for crafting precise interventions aimed at alleviating the burden of CVD within this demographic. Methods: To capture evolving trends pertaining to HIV and CVD and their interplay, this comprehensive review encompassed a thorough search of diverse literature types, encompassing peer-reviewed research, editorials, and research papers. The search spanned various databases, including Google Scholar, PubMed, and the National Library of Medicine's hub, with a particular emphasis on articles bearing the "association" tag. This exhaustive exploration continued through March 28, 2023, with additional pertinent studies identified through a meticulous examination of citations within these articles. This narrative review endeavors to scrutinize the intricate relationship between HIV infection and CVD, elucidate the underlying mechanisms contributing to the heightened risk, and underscore the pivotal significance of early screening and the vigilant management of conventional CVD risk factors among PWLH. Conclusion: An accumulating body of evidence underscores that PWLH confront a significantly augmented risk of CVD in comparison to the general populace. This elevated risk encompasses a multitude of factors, encompassing traditional CVD risk factors, HIV-related variables, chronic inflammation, immune activation, and metabolic perturbations associated with antiretroviral therapy. The proactive screening and meticulous management of traditional CVD risk factors, including hypertension, diabetes, and hyperlipidemia, alongside steadfast adherence to antiretroviral therapy, stand as paramount strategies for mitigating the CVD risk among PWLH. This review underscores the imperative for further research to unravel the intricate mechanisms underpinning CVD in PWLH and to formulate precision-targeted interventions aimed at alleviating the burden of CVD within this population.

Synthesis of Literature: Integrating Disability Models into Non- communicable Diseases and HIV Care

Mwape Muyembe Besa — 2023-11-08

Background: The coexistence of NCDs and HIV poses complex healthcare challenges, requiring integrated care models for improved patient outcomes. This paper explores three integrated service models and examines disability models' relevance to better understand the context. Additionally, it discusses the impact of COVID-19 on individuals with NCDs and HIV, further highlighting the need for comprehensive approaches to address existing disparities. Methods: A literature review was conducted to identify and analyze three integrated care models: Model 1 - NCD programs merged with existing HIV support institutions; Model 2 - Incorporating NCD services into established HIV care settings; and Model 3 - Jointly launched HIV and NCD programs. The paper also delves into disability models, including welfare, medical, and educational/social models. Results: The literature review revealed that Model 1 allows for holistic care during single visits, with AMPATH in Kenya showcasing its effectiveness. Model 2 enhances efficiency by integrating NCD services into primary health care systems, while Model 3 presents implementation challenges that need careful consideration. Disability models provide critical insights into the diverse perspectives surrounding disabilities in the context of integrated care. Individuals with NCDs and HIV encountered heightened vulnerability to severe COVID-19 outcomes. Disruptions in healthcare services affected regular medical check-ups and treatments, potentially impacting disease management. The pandemic exacerbated mental health issues, such as anxiety and depression. Moreover, existing disparities were amplified, resulting in limited access to resources and healthcare facilities. Conclusion: The integration of care for individuals with NCDs and HIV necessitates innovative, patient-centered approaches. Model 1, 2, and 3 offer viable solutions, but their successful implementation requires collaboration and addressing contextual challenges. Disability models aid in comprehending the nuances of integrated care, promoting a holistic understanding of disabilities. The COVID-19 pandemic has further underscored the urgency of integrated care and calls for equitable healthcare systems that address existing disparities. By embracing disability models and comprehensive strategies, healthcare providers can create resilient systems to better serve individuals with NCDs and HIV during pandemics and beyond. Keywords: Integration, Non-Communicable Diseases, NCDs, HIV, COVID-19, Healthcare, Disability Models

inclusive resilience: empowering people living with disabilities in the fight against Covid-19

Patrick Lubasi Mbangweta — 2023-11-08

Background The COVID-19 pandemic has brought unprecedented challenges to societies worldwide, with public health emergencies exacerbating the vulnerabilities of marginalized populations. Among these groups, persons with disabilities face unique and disproportionate hardships during such crises. The United Nations' Sustainable Development Agenda underscores the importance of inclusivity and ensuring the rights of all individuals, including those with disabilities, to lead lives of dignity and security. This paper aims to shed light on the plight of persons with disabilities during the COVID-19 pandemic by reviewing the impact of the virus on their rights and well-being. Methods This review draws on information from the United Nations Human Rights office of the high commissioner, as well as data and examples from various countries across the world. The paper explores specific topics related to COVID-19 and the rights of persons with disabilities. It delves into the challenges faced by individuals who heavily rely on support from others for their daily living, discussing the isolation and difficulties they endure during lockdown procedures. Results The review reveals that persons with disabilities encounter significant obstacles and heightened vulnerability during the COVID-19 crisis. Those reliant on assistance face severe challenges when support systems become inaccessible or disrupted due to lockdown measures. The isolation resulting from restricted mobility and limited support compromises their well-being and survival. Additionally, individuals residing in institutional settings suffer an increased risk of exposure to the virus, leading to alarming death tolls in such facilities. Conclusion The COVID-19 pandemic has shed light on the critical importance of prioritizing the rights and well-being of persons with disabilities during public health emergencies. The review highlights the disproportionate impact of the virus on this vulnerable group, with specific emphasis on those relying on support and those residing in institutions. As societies work to combat and recover from the pandemic, it is imperative to ensure inclusivity and equitable access to healthcare, support services, and essential information for persons with disabilities.

A Synthesis: Exploring the Interconnection between Disability and Covid-19

Wila Lombe — 2023-11-08

Background: The global outbreak of Covid-19 has had far-reaching and devastating consequences, leading to widespread fatalities and the declaration of a pandemic as it rapidly spread across countries. In 2020 alone, there were over 23 million reported cases of Covid-19. Among those impacted, individuals with disabilities constitute a significant and vulnerable group, facing unique challenges in carrying out their daily tasks. The Sustainable Development Goals emphasize the importance of prioritizing the needs and rights of marginalized populations to ensure a life of dignity and safety for all. Unfortunately, people with disabilities are particularly susceptible to the adverse effects of public health crises, such as the Covid-19 pandemic. The primary objective of this review study is to shed light on the various factors contributing to the heightened vulnerability of individuals with disabilities during the Covid-19 pandemic. Methods: To achieve this objective, a systematic search was conducted on Google Scholar using the keywords "COVID- 19 AND DISABILITY" to identify relevant articles. Conclusion: The impact of Covid-19 on individuals with disabilities has been multifaceted, resulting from a combination of factors such as an increased risk of adverse health outcomes, limited access to essential medical care and rehabilitation services, and the profound social consequences of pandemic containment efforts. Through this review, we aim to provide a comprehensive understanding of the relationship between people with disabilities and the Covid-19 pandemic. By highlighting the challenges, they face, we can foster a greater awareness of their needs and advocate for more inclusive and targeted interventions to ensure their well-being and safety during these challenging times. Keywords: Disability, Covid-29, Impairment, People living with disability

Postnatal care knowledge, attitudes and practices: Evidence from mothers

Sharon Kapoma — 2023-11-08

Introduction: According to the literature that has been examined thus far, the majority of factors that lead to new-born and maternal death can be reduced by providing postnatal care. Critical interventions that can put an end to avoidable maternal and new-born fatalities can be given during the first few days after delivery. Postnatal care is essential for the health and survival of both mother and child because this is still the most vulnerable time for both. We therefore set out to investigate the levels of postnatal care knowledge, attitudes and practices among primiparous mothers at Women and New-born hospitals, at University Teaching Hospitals. Materials and Methods: a quantitative cross sectional study approach was used at a national 3rd level hospital. Quantitative data from primiparous postnatal mothers still hospitalized and from outpatient reviews within 6 days of birth were collected using a convenience sampling method; non-probability sampling. A total of 150 primiparous mothers meeting the inclusion criteria were included based on the hospital statistics for primigravida deliveries. Results: under two-thirds (62.7%) of participants had poor knowledge on postnatal care compared to fewer who had adequate knowledge (37.3%). Majority who demonstrated poor knowledge were likely 19 years and below (82.05%) compared to those 20 years and above (55.86%). On attitudes, participants recognized that postnatal care was both important (n = 138, 92.0%) and necessary (n = 137, 91.3%). About practices majority of the study participants did not receive postnatal care from a professional (n = 107; 72.3%) nor did they practice traditional teachings on postnatal care (n = 100, 84.75%). When compared to those who had inadequate awareness of postnatal care, the number of antenatal care visits was higher for those with appropriate knowledge (Mean difference = -1.44; 95% CI: -2.30 to -0.58. Conclusion: Understanding postnatal care is crucial for maternal and new-born outcomes, especially for the younger and more vulnerable mothers. Creating of postnatal care awareness is likely to increase knowledge in this sensitive group with high likelihood of enhancing positive attitudes and practices of the same. Key words: Postnatal care, Primiparous, Postnatal period, Neonatal period.

Uranium exposure-associated health complications and their environmental-exposure pathways: A baseline survey among residents near uranium mining sites in Siavonga, Zambia

Titus Haakonde — 2023-11-08

Background: Uranium (U), a naturally occurring actinide may exhibit radio-toxic or chemo-toxic health effects in exposed populations. Increased cases of environmental uranium pollution have recently gained attention owing to its potential threats to human health and adverse effects on animals and aquatic life. Among the toxicological effects known to arise from environmental exposure to U in humans include neurotoxicity, hepatotoxicity, pulmonary toxicity, reproductive toxicity and bone toxicity. Anecdotal evidence indicating that residents of communities in the vicinity of U-mining sites in Siavonga, Zambia, were experiencing some health complications associated with U exposure have been recorded. Therefore, the current study was conducted with the aim of assessing the associations between specific U exposure-associated health complications, and the potential environmental exposure pathways among residents in the vicinity of the U mining sites in Siavonga, Zambia. Methods: A comparative cross-sectional study design was used. A total of 698 study participants who met the study’s inclusion criteria were randomly included in the study. Pre-tested interviewer-administered semi-structured questionnaires were used for data collection, The collected data was thereafter statistically analysed using a binary logistic regression through SPSS (v 20). Results: The current study results are suggesting that one’s place of residence and the location of drinking water sources had an effect (p< 0.05) on one’s chances of experiencing U exposure-associated health complications. The odds of experiencing U exposure- associated health complications among the U-mining area community residents were at minimum >1.2 among the general populations, >1.6 among pregnant women and >2.014 among children compared to the residents of the non-mining area communities. Conclusions: The findings of the study revealed that the residents of the U-mining area were exposed to high U levels. Therefore, awareness programs targeting local communities should be initiated to sensitise them on the means and ways of limiting and avoiding exposure to U. Keywords: Uranium exposure; Children; Maternal-related; Health complications; Zambia

Approaches and conceptions of learning among physiotherapy students in the University of Ghana

Salma Iddris — 2023-11-08

Background: Approaches and conceptions of learning are important descriptors of learning. Deep, strategic, and surface approaches are the three different approaches adopted by students. The approaches and conceptions of learning of physiotherapy students in Ghana appears to be unknown. The study aimed at determining the study approaches and conceptions of learning among physiotherapy students. Methods: This cross-sectional study involved 101 physiotherapy students who were purposively recruited from levels 100 to 400. Approaches to learning were assessed using the Approaches and Study Skills Inventory (ASSIST) and conceptions of learning were measured using the Conceptions of Learning Inventory (CLI) which identified six conceptions of learning. Spearman’s correlation was used to test association between the approaches and conceptions of learning of the participants. Results: Of the 101 participants, 21 (20.8%), 29 (24%), 37 (30.6%) and 14 (11.6%) were first, second, third- and fourth-year students. A statistically significant difference existed between the strategic and deep approaches (p-value = 0.000), as well as, deep and the surface approaches (p-value= 0.004) of the participants. No significant relationship existed between the approaches of learning and conceptions of learning of the participants. However, deep approach was directly correlated with the conception of seeing learning as a duty only (Rho = 0.02). Conclusion: Majority of physiotherapy students at University of Ghana adopt strategic approach to learning and conceived learning as remembering, using and understanding materials being learnt in class. The conceptions of learning did not have any influence on the learning approaches of most students. Keywords: Learning approaches, conceptions of learning, learning styles, study approach

Exploring the qualitative aspects of peer educator development and assessing training program suitability for adolescent reproductive health in Zambia

Esther Munalula Nkandu — 2023-11-08

Background: In Zambia, addressing the multifaceted challenges in adolescent reproductive health has become increasingly imperative as the youth population continues to grow. Peer education programs, a key strategy, leverage the influence of peer dynamics and relatability for effective knowledge dissemination and behavior change among adolescents. However, a lack of standardized guidelines for training adolescent peer educators has led to significant variations in program duration, age criteria, and content among different organizations. To address this issue, stakeholders in Zambia collaborated to create a preliminary training program tailored to the unique needs of adolescent peer educators, emphasizing interactive activities and dynamic discussions. Methods: To develop the training program, extensive data synthesis was conducted. Findings from FGDs were combined with stakeholder input, utilizing a triangulation approach to ensure a well-rounded understanding. This method, based on Fern's concept, involves examining the subject from multiple angles and drawing insights from various research components, emphasizing the need for factual data sources. Diverse data collection methods, including FGDs, document analysis, and stakeholder group interviews, formed the foundation for the training program development, incorporating a wide range of data sources and perspectives. The outcomes of this triangulation process laid the foundation for the meticulous development of the training program, resulting in a holistic understanding and the creation of an effective program. Results: Different organizations' programs were compared, showing variations in duration, age criteria, and content. The study stressed the significance of peer educators in adolescent reproductive health education and the necessity for support, resources, and acknowledgment. Challenges faced by peer educators were discussed, and their relevance to psychological theories was noted. A summary is presented in vital peer education concepts, including age-appropriate training, peer learning, peer educator benefits, cultural sensitivity, and the value of support and supervision. Conclusion: The study underscores the importance of peer educators in adolescent reproductive health education, highlighting the need for support and recognition. Findings reveal variations in training programs and underscore the value of addressing challenges faced by peer educators. Ultimately, the study calls for a more standardized and supportive approach to enhance the effectiveness of such programs.

Investigating social-cultural factors contributing to low reporting levels of gender-based violence cases

Muchinga Mutambo — 2023-11-08

Introduction: Gender-based violence remains a critical societal concern, characterized by both its prevalence and the challenge of underreporting. Understanding the social-cultural factors contributing to low reporting levels of GBV cases is essential for effective intervention. This qualitative case study aimed investigating the social-cultural factors that hinder the reporting of GBV cases within the context of Chibuluma compound in Zambia's Copperbelt Province. Materials and Methods: Employing qualitative methods, the study involved interviews and focus group discussions with key stakeholders including police officers, YWCA officials, and women residing in the compound. Results: The findings reveal a complex interplay of factors that contribute to low reporting levels of GBV cases. Economic dependency on spouses, cultural norms that tolerate violence, and lack of trust in the judicial system emerged as prominent barriers. Marital violence took various forms, including wife battery, abandonment, and infidelity Conclusion: The study highlights the necessity of collaborative efforts involving governmental agencies, non- governmental organizations, and international bodies to effectively address GBV. Recommendations include fostering women's economic empowerment, strengthening legal enforcement mechanisms, and challenging cultural norms that perpetuate violence. By uncovering the intricate socio-cultural dynamics contributing to underreporting, this research offers valuable insights for designing comprehensive strategies to combat gender-based violence in Chibuluma compound and beyond.

Maternal factors associated with birth asphyxia at the University Teaching Hospitals, Lusaka, Zambia

Mabvuto Zulu — 2023-11-08

Background: Birth asphyxia is associated with significant perinatal complications. The World health organization (WHO) estimates that 3% of neonates born each year develop asphyxia and need resuscitation (WHO 2016). Because of the paucity of data and enormous magnitude of birth asphyxia, available figures are likely to underestimate the proportion of the problem (WHO 2016). Research is needed to estimate the contribution of birth asphyxia to perinatal morbidity and mortality at the University Teaching Hospital (UTH), Lusaka, Zambia. Methodology: A case control study comprising 72 newborns from labour ward with birth asphyxia (Apgar score <7) (n=72) and 125 well newborn presenting to the postnatal ward and having been delivered within UTH from 1st November 2015 to January 2016 was conducted. A questionnaire was used to collect data along with medical records of the newborn. A multiple logistic regression model was used to assess the association of maternal obstetric conditions and birth asphyxia while controlling for confounders. Results: Of the 197 patients enrolled, 72 had birth asphyxia of which 37 were born with mild birth asphyxia (Apgar score 4-6) while 35 were born with severe birth asphyxia (Apgar score 1-3). Neonates delivered by spontaneous vaginal delivery had 88% reduced odds for birth asphyxia [ Odds Ratio (OR) 0.12, 95% Confidence Interval (CI) 0.05 – O.31, P- value< 0.01]. Neonates with birth weight between 2500-3500g had on average 96% reduced odds ratio for birth asphyxia (OR 0.04, 95% CI 0.02-0.11, P- value < 0.01) compared to neonates with birth weight above 3500g. Compared to newborn of mothers with parity greater than four, neonates born of mothers with parity=1 had on average 79% reduced 0dds for birth asphyxia (OR 0.21, CI 0.07-0.70, P-value=0.01). Neonates born of mothers with parity between 2 and 4 had on average 96% reduced odds (OR 0.04, 95% CI 0.01 – 0.12, P- value < 0.01). Conclusion: High parity and newborn with birth weight >3500g were associated with birth asphyxia. Marital status and education level did not increase the risk of birth asphyxia in the population studied. Keywords: birth asphyxia, maternal factors, parity, labor

Empowering Ideal Peer Educators: Insights from Adolescent Reproductive Health Programs in Zambia

Esther Munalula Nkandu — 2023-11-08

Background: Peer education is crucial for youth, employing relatable educators to drive behavioral change and disseminate information, particularly in adolescent reproductive health. These educators' approachability and credibility stand in contrast to intimidating adult counterparts. Beyond knowledge, peer education's effectiveness stems from ongoing social interactions and role modeling. In Zambia, standardized adolescent reproductive health education for peer educators faces challenges. Some programs lack comprehensive assessments, leaving their impact uncertain. Essential peer educator attributes remain undefined, hindering program optimization, especially in addressing health threats like HIV/AIDS. This article delves into peer educators' roles, traits, transformative training effects, and influencing factors. Methods: This study aimed to develop a robust research methodology rooted in the interpretive paradigm, utilizing Focus Group Discussions (FGDs) to explore adolescent reproductive health education and peer educator training. Stakeholder workshops, data validation, and verbatim reporting were employed to ensure data credibility. The research process involved three phases, focusing on stakeholders, adolescents, and program development. Results: FGDs with trained peer educators revealed defining characteristics of ideal peer educators, emphasizing knowledge, communication skills, ethical behavior, and role modeling. The training program positively impacted peer educators, enhancing self-esteem, knowledge, and empowerment. Key factors influencing peer educators included comprehensive training, family support, and adherence to Christian values. Negative factors encompassed a lack of incentives, limited resources, and insufficient recognition. Peer educators in different regions reported significant personal growth and a deep commitment to their roles. Conclusion: This study underscores the importance of ideal peer educators possessing knowledge, effective communication skills, ethical behavior, and a commitment to promoting positive behaviors. Continuous training, support, and recognition are essential for peer educators to address evolving challenges effectively. Peer education programs should prioritize these elements to empower peer educators and enhance their ability to address the complexities of adolescent reproductive health.

Compounding effects of COVID-19 on health and socio-economic needs of artisanal small-scale gold miners at Chawagona site, Bindura, Zimbabwe

Gugulethu Dube — 2023-11-08

Background: COVID-19 pandemic has apart from causing infections and deaths ravished worldwide economies on a level not experienced before. This disease has shown that it can potentially affect businesses, livelihoods, industries, communities and overwhelm health systems. The ASGM sector which faces a plethora of existing challenges, has not been exempted from these shocks. The intention of this study was to investigate the compounding effects of COVID- 19 on the health and socio-economic needs of ASGM in Chawagona farm. Methods: A mixed methods approach was carried out. The quantitative aspect employed a descriptive non- interventional cross-sectional study and the qualitative component, a case study. A logistic regression model, chi- square and a t-test were used as estimation techniques. Statistical package used was Stata 16. Qualitative data analysis used thematic analysis with CAQDAS. Multiphase sampling techniques were adopted for the survey and in-depth interviews with a total of 181 respondents, all ASGM at Chawagona farm, Bindura, Zimbabwe. Results: Study indicated that COVID-19 severely affected respondents’ main source of income, food security and thereby affecting their health and livelihoods. Results show an association between loss of income and socio- demographic characteristics such as sex, role in the ASGM, education, age, accommodation, household size. They also show that apart from the existing socio-economic conditions, the ASGM KAPs around COVID-19 are influenced by lack of information, lack of access or barriers to health care are more likely to promote non-compliance with preventive protocols. Conclusion: COVID-19 has compounded the vulnerabilities of ASGM, who already had pre-existing health and socio-economic challenges. As such, there is need for multiple stakeholder interventions in improving health access, structural support, income stabilization, food security and recovery of livelihoods, during and post the pandemic. Therefore, the study promoted the adoption of a broader approach to build capacity and resilience in the ASGM communities in the event of future pandemics. . Keywords: Artisanal small-scale gold miners, COVID-19, health, socio-economic, pandemic

Efficacy of Constraint Induced Movement Therapy and Mirror Therapy in Improving Upper Extremity Function in Late Subacute and Chronic Stroke Patients: A randomized crossover trial

Olipa Zulu — 2023-11-08

Background: To investigate the efficacy of the combination of Constraint Induced Movement Therapy and Mirror Therapy on functional outcome of the upper extremity for patients with late subacute and chronic stroke. Materials and Method: This study was a single-centre, randomized, single subject blind, 2-way crossover. Recruited 12 participants who had chronic stroke treated at the University Teaching Hospital, department of physiotherapy, Lusaka. Patients were randomly assigned in the group (n=6) of combined therapy or to a group (n=6) of conventional therapy. Microsoft Excel was used for randomization and trial group allocation. The data from the same type of treatment in the two sequences were combined and analysed. The primary analysis compared the range of motion and motor function in the two groups at 6 weeks of follow-up. Results: Constraint Induced Movement Therapy with Mirror Therapy produced a significant improvement in range of motion, activities of daily living, and motor function (p<0.016). No significant improvement was observed in the quality of life for either treatment group. However, no significant differences were found between the Constraint Induced Movement Therapy and Mirror Therapy and conventional physiotherapy in terms of improving range of motion, motor function, activities of daily living, and quality of life. Conclusion: Overall, the combination of Constraint Induced Movement Therapy and Mirror Therapy showed better improvement over conventional physiotherapy in the management of upper extremity impairment in late subacute and chronic stroke regarding the range of motion, motor function, and activities of daily living in chronic stroke patients. Keywords: Stroke, Constraint Induced Movement Therapy, Mirror Therapy, Functional Activity, Upper Extremity, Conventional Physiotherapy

Understanding adolescent perspectives on fertility control during Covid-19

Siphiwe Sakala — 2023-11-26

Background: This study investigates adolescents' perspectives on fertility control strategies during the COVID-19 pandemic in the urban township of Lusaka District. The background highlights existing challenges, such as high HIV rates and teenage birth rates. The research adopts a mixed-methods approach, utilizing in-depth interviews and structured questionnaires. The study involves 20 adolescents and 5 healthcare workers for qualitative data and 130 adolescents aged 13-24 for quantitative data, selected through purposive and convenience sampling. Results: The findings reveal that a majority of participants are sexually active, using contraceptives, with a noteworthy proportion experiencing pregnancies despite contraceptive use. Vaccination status is linked to contraceptive use. Factors such as social support, economic support, spiritual/religious influence, self-efficacy, and assertiveness in sexual situations significantly influence the inclination to abstain from sexual intercourse. Higher education and older age are associated with increased contraceptive use. Some participants report being affected by COVID-19, citing challenges like condom shortages, strict measures, and fear of infection. Healthcare workers note the pandemic's impact on contraceptive accessibility, contributing to a surge in unwanted pregnancies and sexually transmitted diseases among young people. Conclusion: The study concludes by emphasizing the necessity of enhancing contraceptive access and promoting safer sex practices, particularly targeting less-educated individuals, those with limited economic and social support, and younger demographics.

Impacts of the Covid-19 pandemic on standard care for stroke patients at Our Lady’s Hospice of Kalingalinga and University Teaching Hospitals in Zambia

Erick Mwale — 2023-11-26

Background: The COVID-19 pandemic has posed unprecedented challenges to healthcare systems globally. This study investigates the impact of the pandemic on routine care for stroke patients, focusing on physiotherapy services at Our Lady’s Hospice of Kalingalinga and University Teaching Hospitals in Lusaka. Methods: A quantitative cross-sectional approach was employed, enrolling 43 stroke patients. Demographic characteristics, institutional variations, and session delays were analyzed for two periods: before (October-December 2019) and during the pandemic (March-May 2020). Results: The majority of participants (51-70 years old) demonstrated consistent attendance patterns, with females outnumbering males. Institutional shifts during the pandemic revealed decreased attendance at the University Teaching Hospitals and a slight increase at the hospice. Delays in session appointments surged during the pandemic, emphasizing the challenges faced by stroke patients. Conclusion: This study highlights the disruptive effects of the COVID-19 pandemic on routine stroke care, emphasizing the need for adaptive healthcare strategies to ensure continuous and timely services for this vulnerable population during public health crises.