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Factors associated with awareness of the law banning public smoking and reasons behind smoking in public in Kalingalinga township, Lusaka
No full textThis study was aimed at assessing awareness levels of the law banning public smoking, determine socio-economic predictors of awareness of the same law as well as reasons behind public smoking, using Kalingalinga Township as a study site. The study also aimed to establish efficient and effective forms of media for relegating tobacco legislative information. This was a cross-sectional study of 420 households of Kalingalinga Township in which a structured questionnaire was used to collect information.The hazardous effects of tobacco smoking on health have been re-echoed world all over for over half a century now. Nearly, 80 % of the world’s tobacco-related deaths occur in low and middle income countries. Zambia, a middle income country and a signed party to the World Health Organization Framework Convention on Tobacco Control (WHO, FCTC) has instituted restrictive policies (laws) to curb cigarette smoking behaviour. The Public Health Act Cap 295 enforced into a punishable offence by the introduction of Statutory Instrument No. 39 of 2008 of the Local Government forbids smoking of cigarettes in public places. However, despite the existence of this law cigarette smoking behaviour, even in public places, estimated at 19% for males above the age of 15 and 2% for women above the age of 15 years is believed to be on an increase in Zambia and the rest of Africa.
The objectives of the study were to assess awareness levels of the law banning public smoking, determine socio-economic predictors of awareness of the same law as well as reasons behind public smoking, using Kalingalinga Township as a study site. The study also aimed to establish efficient and effective forms of media for relegating tobacco legislative information. This was a cross-sectional study of 420 households of Kalingalinga Township in which a structured questionnaire was used to collect information. The 420 households were selected by way of systematic sampling procedure and participants of consenting age were the only ones included in the study. The information collected was entered and analysed using Stata V.12.
The study found 60.71% of the participants were aware of the law banning public smoking. Of the whole respondents 16.8% were totally aware of all aspects of the law; when the law was instituted and how long a person can be jailed for. Those merely aware of when the law was instituted were 31.76 % whilst those aware of how long a person can be jailed for were 35.07 %. The odds of being aware of the law banning public smoking, for those in constant touch with some form of media (Television, Newspaper, Radio) were 1.78 (p< 0.001, C.I 1.54 - 2.05) to none. Television was found to be the most effective and efficient form of media accounting for 33% awareness whilst the Radio 16% and News paper 17%. The majority in the smoker group (54 %) as well as the majority in the non-smoker group (34%) were both of the view that public smoking is due to lack of enforcement of the law prohibiting public smoking.
From the findings, it is recommended that policy makers consider using television more than any other form of media when promulgating information of statutory nature on tobacco or any information related to tobacco smoking since it has the greatest coverage and impact. Policy makers should also consider strict enforcement of the law prohibiting public smoking to promote awareness of the same law and to curb tobacco smoking behaviour believed to be on an increase. Lastly, research to assess and determine challenges faced with implementation of the law banning public smoking seems imperative since no such research has been conducted before.
Keywords: Public smoking, Tobacco legislature, Public Health, Tobacco contro
Diabetic retinopathy among patients attending university teaching hospitals adult hospital medical clinic in Lusaka
No full textThesisDiabetic retinopathy (DR) is a common microvascular complication of diabetes
mellitus and also a leading cause of visual impairment among people in the working
age group. Retinopathy develops overtime in all diabetics and controlling the
modifiable risk factors delays its onset and progression. This study was carried out to
assess DR; its prevalence and associated clinical/demographic characteristics among
patients attending the UTHs-Adult Hospital medical clinic in Lusaka, Zambia.
This was a hospital-based cross-sectional study carried out from 18th December,
2018 to 16th April, 2019 at the adult medical diabetic clinic. Snellen visual acuity
(VA), blood pressure, weight and height were measured as well as relevant
demographic and medical information collected. Retinal images were captured after
pupil dilatation and used for grading retinopathy using the International classification
of DR scale. The worse eye was used to grade for DR.
A total of 213 participants were studied with a female to male ratio of 2.3:1. The
median age was 53 years and majority (183=85.2%) had type 2 diabetes. Median
duration of diabetes was five years with insulin therapy being the most common
(115=54.5%) diabetes control measure. Anti-hypertensive medication was being
used by 87 participants (40.9%). Median glycated haemoglobin level was high at
8.1%. One hundred sixty-three participants (76.5%) had normal VA and six (2.8%)
were blind.
The prevalence of DR in this study was 47.4%; 95% CI 40.8%-54.2% (101
participants), with 8.9% (19 participants) having proliferative diabetic retinopathy.
Diabetic macula oedema was present in 24 (11.3%; 95% CI 7.5%-16.1%). Duration
of diabetes was the most significant (p<0.0001) association found with retinopathy;
as well as alcohol intake and having diabetic foot (another microvascular
complication).
Even though 104 participants (51.1%) had the knowledge that diabetes affects the
eyes, only 55 (25.8%) had had a dilated eye examination in the preceding twelve
months.
The study findings suggest that better advocacy for retinopathy screening and
diabetes control needs to be implemented at the UTHs-Adult Hospital in Lusaka.
Keywords: Diabetic retinopathy, prevalence, risk factors, dilated eye
examinatio
Prévention du Paludisme, de la tuberculose, de l'hépatite B et de l'infection au VIH :connaissances, attitudes et pratiques des accompagnants des patients hospitalisés dans le service de maladies infectieuses du CHU- Point G.
No full textNotre étude s'est déroulée au service de maladies infectieuses sur une période allant du 19 Septembre 2018 au 19 Février 2019. Cétait une enquête transversale à visée descriptive et analytique au cours de laquelle nous avons colligé 150 accompagnants des patients hospitalisés au sein du service des maladies Infectieuses du Point G dans le but d'évaluer leurs connaissances, attitudes et pratiques à titre préventif du Paludisme, de la tuberculose, de l'hépatite B et de l'infection au VIH. La femme, de par son rôle de gardienne de la famille (et donc de la société) se retrouve au premier plan dans cette activité (52 p.100 dans notre étude). Les caractéristiques de l'accompagnant retrouvé dans notre étude est celui de membre de la fratrie, d'âge mur, marié, commerçant de profession ou femme au foyer, ayant le plus souvent un niveau d'instruction inferieur ou égale au primaire et provenant de la ville de Bamako. Leur niveau de connaissance sur le mode de transmission et les moyens de prévention du paludisme et de la tuberculose étaient mauvais. Mais pas aussi bas que celui de l'hépatite B qui restait la maladie la moins connue de toutes ces affections. Les accompagnants connaissaient en majorité les modes de transmission du VIH mais très peu en savaient comment s'en protéger. Leurs attitudes et pratiques vis-à-vis de ces maladies sont aussi insuffisantes. La majorité les savent grave et s'y sentent exposés mais très peu s'attèlent à s'en protéger. Les insecticides sont beaucoup plus sollicités que les MII pour se protéger contre le paludisme. Nombreux sont ceux qui aèrent les chambres que portent les bavettes pour se protéger contre la tuberculose. La majorité ne posent pas de gestes adéquats pour prévenir le VIH et l'hépatite B ; bien vrai que les mass media (télévisons et radio) soient les plus citées comme source d'information sur ces maladies. Certains moyens de préventions sont souvent beaucoup plus disponibles qu'utilisés à bon escient (eau de javel et gants). Notre étude a aussi retrouvé le niveau d'instruction, le lieu de résidence, le nombre d'accompagnements antérieurs et le genre de l'accompagnant comme facteurs influençant les connaissances attitudes et pratiques des accompagnants de façon variable pour le paludisme, la tuberculose, l'infection au VIH et l'hépatite B
: L’utilisation des méthodes contraceptives modernes à l’unité de PF du CS Réf CVI
No full textIl s’agit d’une étude transversale descriptive dans laquelle les éléments de l’enquête sont revus à l’intervalle régulier au cours de l’année. L’étude s’est déroulée du 1er janvier 2018 au 31 décembre 2018 soit une période de 12 mois. Notre objective était d’étudier les facteurs associés à l’utilisation des méthodes contraceptives modernes à l’unité PF du CSRef CVI . La majorité d’entre elles étaient mariées ; 90,71% contre 8,32% pour les célibataires. . Les sources d’information sur la planification familiale, les plus citées étaient des agents de santé, les amis, les médias, alors que les parents étaient rarement cités comme source d’information. L’utilisation des implants était prédominante avec 46,88% de notre échantillon. Les métrorragies, ont été les plus fréquentes soit 40,22% des effets indésirables. Enfin, celles qui discutent couramment avec leurs conjoins et qui avaient obtenu leur soutien, avaient aussi plus de chance d’utiliser les contraceptives modernes. Donc ces facteurs devraient être soutenus afin d’optimiser l’utilisation des contraceptives modernes pour les femmes en union
Factors influencing non-adherence to antitroviral therapy (ART) among people living with hiv/aids (PLWHA): A case of Isiolo district, Kenya
No full textRA 643.G6 2014In HIV/AIDS treatment adherence to antiretroviral therapy is of paramount importance. To achieve suppression of viral replication, decrease in viral load and improving quality of life needs near perfect adherence of 95%. The researcher had sort to establish factors influencing non adherence among people living with HIV/AIDS in Isiolo District. The researcher used descriptive survey design. Sample population of 193 participants which is 30% of the 640 total study populations was used. This was obtained from the district comprehensive care clinic through document analysis. The raw data was collected using structured questionnaires and focused group discussion which was cleaned, classified, coded processed, analyzed and presented using pie-charts, graphs and tables. Findings show: individual’s income, multiple drugs combination, health care workers perceptions, beliefs and taboos influence non adherence to antiretroviral therapy while counseling helps to create positive altitude and minimizes stigma. The study recommends: Ministry of Health with other stakeholders to solicit funds to form support groups that will stabilize clients emotionally, psychologically and economically. To improve infrastructure, health care workers and public perceptions and altitudes through trainings, public education, barazas and pamphlets. Free treatment of opportunistic infections for patients with pneumonias, malaria and others infections to minimize admissions and improve quality of life
Factors affecting breast, cervical and prostate cancer treatment outcomes in Zambia
No full textThesisCervical, breast and prostate cancers represent 51% cancer mortality and morbidity in Zambia. This study aimed to show their prevalence, incidence trends, describe associated typical patient socio-demographic characteristics and survival factors using the Zambia National Cancer Registry (ZNCR) data collected during January 1st 2008 - December 31st 2015.
We conducted secondary ZNCR data incidence and mortality analyses of by province for these cancers. Data were cleaned using Excel and Epi Info Version 7.2.1.0. Analysis was done in Stata-13 for socio-demographic, treatment and survival factors. We determined annual incidence rates, from the mid-year (2011) onwards; and overall incidence using the mid-year population. Chi tests for trend and independence were used.
Of 10,765 cervical, breast and prostate cancer records analysed, there was an increase in incidence (p<0.001) and death rates during 2008 - 2015.
Most breast cancer patients (56.9%) were aged between 30-54years, 56% were married, 64.3% lived in Lusaka, Eastern and Copperbelt provinces and were commonly treated by chemotherapy (32.9%) and surgery (32.2%). Highest breast cancer case fatality (CFR) and crude death rates (CDR) per 100,000 population were in Lusaka (32.9% and 82) and Eastern (18.9% and 107) respectively. For instance, controlling for marital status a positive HIV status reduced the odds of survival by 40%.
Most cervical cancer patients (61.5%) were aged between 30-54years, 53.1% married, 57.9% lived in Copperbelt, Eastern and Lusaka provinces and were commonly treated by Chemotherapy (37.3%) and Radiotherapy (31.8%). Highest CFRs were in Lusaka (35.9%) and Eastern (14.3%) and lowest (2%) in Muchinga provinces, but Copperbelt province had the lowest CDR at 210/100,000 people. Controlling for marital status, HIV status and age, Radiotherapy increased the odds of survival by 70%.
Most prostate cancer patients were aged between 60-84years, 54% were married and were commonly treated by Chemotherapy (34.1%) and surgery (29.6%). Lusaka (43%) and Eastern (13.1%) provinces had highest prostate cancer CFRs and a CDR of 310/100,00 population. Controlling for age, surgery, chemotherapy, radiotherapy and province of birth, being married increased the odds of surviving from prostate cancer 7.5 times.
Breast and cervical cancers in Zambia mainly affected those younger than 55years while prostate mainly affected those older than 60 years and increased with age. Age, surgery, marital status and province of residence appear to have a major effect on morbidity and survival. Early screening programmes can help address these cancers.
Key words: breast cancer, cervical cancer, prostate cancer, Zambi
Perspectives and practices of self-medication in Shibuyunji district, Lusaka province, Zambia
No full textThe concept of self-medication which encourages an individual to look after minor illnesses with simple and effective medicines has been adopted worldwide. Although self-medication has been reported to have several benefits, it has also been associated with many risks. Self-medication among poorly informed segments of the population may result in a waste of household and government resources. Regardless of the growing research attention in self-medication, little information has been available about perspectives and practices of self-medication especially in developing countries. In Zambia, particularly the study site, little information is available on the subject. The purpose of this study was to explore the perspectives and practices of self-medication.
A qualitative case study design was used. A total number of 63 participants participated in the study, four (4) focus group discussions, six (6) key informant interviews and 22 in-depth interviews were conducted during data collection. The study incorporated free listing and pile sorts in focus group discussions and In-depth interviews. Key informant interviews were also conducted with relevant individuals. Purposive sampling using maximum variation was used to select study participants. Data was analysed using grounded theory to see how emerging issues were related. From the information recorded in each interview and discussion, major themes and sub-themes were identified.
The findings of the study revealed that the study participants did not follow a specific dosage or timeframe when self-medicating. Both health workers and the general population follow the same pattern when self-medicating. However, health workers perceived self-medication as being risk while the general population viewed it as being of benefit to them. The results also showed that diseases that are seen to be relatively minor and common, self-medication would be preferred. On the other hand, if the disease was thought to be severe, unfamiliar or injuries, the patient would much more likely go to the health centre for treatment.
In conclusion, self-medication practices are influenced among others by income, distance to health facility, condition of the disease and disease severity. People don‟t have a specific dosage and duration to follow when self-medicating. The perceived benefits of self-medication are likely to result in it being a common health seeking behaviour.
Key words: Self-medication, Practices, Perspectives, Responsible self-medication
Cotation des accidents vasculaires cérébraux en hospitalisation au service de neurologie du CHU du point-G : aspects clinique et pronostic.
No full textIl s’agit d’une étude prospective et descriptive menée dans le service de neurologie du centre hospitalier universitaire (C.H.U) du Point G à Bamako au Mali sur une période allant du 1er septembre 2018 au 28 février 2019. Ont été enrôlés patients ayant présenté un déficit neurologique d’installation brutale, ayant persisté plus de 1h et sans symptômes résolutifs au moment de leur hospitalisation chez qui un scanner cérébral a été réalisé, et qui ont été hospitalisé dans un délai de 14 jours suivant la date de l’accident.
Notre étude a porté sur 100 patients, l’âge moyen était de 56 ans avec des extrêmes allant de 23 à 89 ans et le sexe ratio était de 1,7 en faveur des hommes. L’HTA était le principal facteur de risque modifiable retrouvé avec 77% de patients hypertendus.63% des patients résidaient à Bamako et ses environs et 41 % avaient réalisé un scanner cérébral dans les 24 premières heures. Les accidents ischémiques constitués prédominaient avec 62% des cas. 21% des patients étaient hospitalisés dans les 24 premières heures et la durée moyenne du séjour hospitalier était de 7 à 14 jours. Un score de Glasgow de 15/15 était retrouvé chez 75% des patients et les scores de NIHSS, Barthel et Rankin modifiés étaient mesurés à l’entrée, à la 72ème heure et à la sortie. Ainsi donc à la sortie les scores de NIHSS, de Barthel et de Rankin modifiés évoluaient favorablement respectivement chez 37%, 45% et 44% des patients. La majorité des patients, soit 91%, ont bénéficié de la kinésithérapie motrice et 48% d’entre eux ont eu leur première séance entre le 4ème et le 7ème jour suivant la survenue de l’AVC
Seasonality of Cryptosporidium oocyst detection in surface waters of Meru, Kenya as determined by two isolation methods followed by PCR
No full textMeru, Kenya has watersheds which are shared by wildlife, humans and domesticated animals. These surface waters can be contaminated by the waterborne pathogen Cryptosporidium. To quantify the seasonality and prevalence of Cryptosporidium in Meru regional surface waters, we used a calcium carbonate flocculation (CCF) and sucrose floatation method, and a filtration and immunomagnetic bead separation method, each of which used PCR for Cryptosporidium detection and genotyping. Monthly water samples were collected from January through June in 2003 and 2004, bracketing two April-May rainy seasons. We detected significant seasonality with 8 of 9 positive samples from May and June (p<0.0014), which followed peak rainy season precipitation and includes some of the subsequent dry season. Six of 9 positive samples revealed C. parvum, and 3 contained C. andersoni. None contained C. hominis. Our results indicate that Meru surface waters are Cryptosporidium-contaminated at the end of rainy seasons, consistent with the timing of human infections reported by others from East Africa and contrasting with the onset of rainy season peak incidence reported from West Africa
