19 research outputs found
Haemodynamic changes and peripheral vascular characteristics associated with pathophysiological alterations in Preeclampsia patients at the University Teaching Hospital, Lusaka, Zambia
Get PDFBackground: The circadian blood pressure changes in pregnancy are poorly documented though the severity of hypertensive disorders especially in pregnancy is said to be better detected by 24hour blood pressure monitoring. The contribution of peripheral vascular variations to these alterations is yet to be elicited. The association of these changes to the renal pathological dysfunction is also not fully understood.Materials and method: Ambulatory blood pressure measurements and kidney function tests (i.e. creatinine, protein, sodium and uric acid) were done in patients admitted to UTH for hypertension in second and third trimesters of pregnancy. The Complior was used to determine the pulse waveform, pulse wave velocity (PWV) and augmentation index (Aix) as surrogate parameters for peripheral vascular compliance.Results: Twenty-six (26) women, between 22-42 years old and 24-36 gestational weeks, participated in this study. The majority of our population were either non- or reverse dippers (91.6%). The type A pulse waveform was dominant in all three groups indicating endothelial dysfunction. Dippers had a higher creatinine concentration in both urine and serum and uric acid in serum than non-dippers (7.051mmol/24hrs; 108.703ìmol/L;0.507mmol/L; respectively p<0.0001). The observed association of diurnal variations inhemodynamic parameters and dipping status indicates significant vascular pathology that may herald these individuals' increased risk of cardiovascular complications. The dominance of the type A pulse waveform in this population is indicative of significant endothelial dysfunction.Conclusion: The association seen between elevated blood pressure readings and proteinuria indicates a possible common pathophysiological process that leads to increased porosity at the glomeruli.
Keywords: Diurnal blood pressures, preeclampsia, arterial stiffness, pulse wave velocit
Effects of High-Intensity Aerobic Interval Training on Cardiopulmonary Function in Patients With Chronic Heart Failure at The University Teaching Hospital, Lusaka, Zambia
Get PDFChronic heart failure patients present with various symptoms, such as fatigue and dyspnea, adversely affecting their quality of life. Heart failure is a complex disease and a major cause of morbidity and mortality in developed and developing countries, including Zambia. Through studies undertaken, high-intensity aerobic interval training has been recommended in patients with chronic heart failure to help improve symptoms and, consequently, the quality of life. Minimal research pertaining to the effectiveness of aerobic exercise on various physiological parameters such as peripheral oxygen saturation, cardiopulmonary capacity and quality of life have been done in Africa and Zambia. This study evaluated the physiological effects of high-intensity aerobic interval training on the cardiopulmonary function in New York Heart Association (NYHA) Class II and III chronic heart failure patients with a focus on peripheral oxygen delivery/saturation, cardiopulmonary capacity and the quality of life. This study utilised the Randomised Clinical Trial (RCT) study design, and the study population was selected from the University Teaching Hospital-Heart Clinic in Lusaka, Zambia.A total number of 42 patients participated and were randomly assigned to the two arms of the study. Twenty-one (21) were assigned to the interventional group (IG) and 21 to the control group (CG), respectively. The IG underwent a 12-week aerobic HIIT exercise-training programme, while the CG was subjected to 30 minutes of walking on a treadmill for the same period of 12 weeks. The expected primary outcomes were the baseline to endline differences in oxygen delivery/saturation readings, cardiopulmonary capacity test readings and the quality of life (measured using the Minnesota questionnaire) for both groups. The results obtained from the pulse oximeter readings showed an increase in the oxygen saturation readings (97.90 to 98.62%), 6-minute walk distance readings (360.05 m to 429 m) and the questionnaire score totals of the different dimensions (physical, emotional/mental and socio-psychological factors) of the questionnaire (p-value;0.0001) of the IG. The CG oxygen saturation readings (97.38 % to 97.90%) and 6-minute walk test scores (359.14 to 370.9 m) showed minimal change. While the questionnaire scores showed a statistical difference in the emotional/mental (p-value < 0.0001), physical (p=0.005) and socio-psychological factors (p-value < 0.0001). High-intensity aerobic interval training has shown to improve peripheral oxygen delivery, cardiopulmonary capacity and quality of life in chronic heart failure patients; hence, it must be considered an adjunct therapy aside from pharmacological management in stable chronic heart failure patients in Zambia
Pulmonary Function Responses to Active Cycle Breathing Techniques in Heart Failure Patients at the University Teaching Hospital (UTH), Lusaka, Zambia
Get PDFChronic heart failure patients experience restrictive respiratory dysfunction, resulting in alterations of FEV1, FVC and FEV /FVC as demonstrated in exercise 1 intolerance, dyspnoea and poor quality of life (QoL). Active Cycle of Breathing Techniques (ACBT) is traditionally used by Physiotherapists in the management of respiratory conditions. The aim of this study was to investigate the physiological effects of ACBT on pulmonary function in stable heart failure (HF) patients (New York Heart Association Functional class II and III) at the University Teaching Hospital (UTH) in Lusaka, Zambia.Methods: This prospective cohort study investigated the pulmonary function response to ACBT in heart failure patients at UTH Lusaka, Zambia. A Minnesota questionnaire was used to collect anthropometric and QoL data; respiratory function tests were done by a handheld spirometer at baseline, 6 weeks and 12 weeks. ACBT were conducted on 3 days of the week for a total of 12 weeks. STATA version 11.2 was used for data analysis.Results: A total of 23 patients, mean age 54.0 years (range 25-77), participated in the study. The lung function volumes were reduced at baseline as expected (FVC = 2.9L, FEV1 = 2.0L and FEV1 /FVC = 70.1%). There was hardly any change at 6 weeks (FVC = 2.7 L, FEV1 = 1.9 L and FEV1 /FVC = 70.2 %). There was a slight increase in the means at 12 weeks (FVC = 2.8L, FEV1 = 2.0 L and FEV1 /FVC = 73.0%) which was statistically insignificant (p= 0.73). However there was a statistically significant improvement in quality of life at both 6 and 12 weeks of intervention ((p< 0.0001).Conclusion: ACBT exercises facilitate modest increases in ventilatory function but significantly improve HF related symptoms, greatly improving the quality of life in heart failure patients.Key Words: Heart Failure, Active Cycle of Breathing Techniques, Spirometry, Pulmonary Function and Quality of Lif
The institutional context of tobacco production in Zambia
No full textAbstract Background Tobacco production is said to be an important contributor to Zambia’s economy in terms of labour and revenue generation. In light of Zambia’s obligations under the WHO Framework Convention of Tobacco Control (FCTC) we examined the institutional actors in Zambia’s tobacco sector to better understand their roles and determine the institutional context that supports tobacco production in Zambia. Methods Findings from 26 qualitative, semi-structured individual or small-group interviews with key informants from governmental, intergovernmental and non-governmental organisations were analysed, along with data and information from published literature. Results Although Zambia is obligated under the FCTC to take steps to reduce tobacco production, the country’s weak economy and strong tobacco interests make it difficult to achieve this goal. Respondents uniformly acknowledged that growing the country’s economy and ensuring employment for its citizens are the government’s top priorities. Lacklustre coordination and collaboration between the institutional actors, both within and outside government, contributes to an environment that helps sustain tobacco production in the country. A Tobacco Products Control Bill has been under review for a number of years, but with no supply measures included, and with no indication of when or whether it will be passed. Conclusions As with other low-income countries involved in tobacco production, there is inconsistency between Zambia’s economic policy to strengthen the country’s economy and its FCTC commitment to regulate and control tobacco production. The absence of a whole-of-government approach towards tobacco control has created an institutional context of duelling objectives, with some government ministries working at cross-purposes and tobacco interests left unchecked. With no ultimate coordinating authority, this industry risks being run according to the desire and demands of multinational tobacco companies, with few, if any, checks against them
Tobacco Use among HIV-Positive and HIV-Negative Women and Men in Zambia—Demographic and Health Survey, 2018
No full textCountry-specific estimates of tobacco use among people living with HIV (PLWH) are lacking for much of sub-Saharan Africa. We aim to evaluate the association between the HIV status and tobacco product use status, frequency, and intensity, using nationally representative data from Zambia. We analyzed data from the 2018 Demographic and Health Survey conducted in Zambia among women aged 15–49 years and men aged 15–59 years. We performed logistic regression to assess the associations of HIV status, selected sociodemographic, and other characteristics with indicators of tobacco use (i.e., status, frequency, and intensity). Among women, 14.3% tested positive for HIV and 2.7% reported current smoking or tobacco use; women living with HIV were more likely to report currently smoking or using tobacco than women living without HIV (4.4% vs. 2.4%; aPR: 1.46). Among men, 8.4% tested positive for HIV and 19.5% reported current smoking; men living with HIV were more likely than men living without HIV to report current smoking (27.8% vs. 18.7%; aPR: 1.22). Several sociodemographic characteristics were associated with tobacco use, including age, residence (urban/rural), education level, employment status, and wealth index. The frequency and intensity of smoking among men who currently smoked did not differ by HIV status. Tobacco use was more likely in PLWH than those without HIV in Zambia. Our findings highlight the need to encourage and support tobacco cessation among PLWH, possibly by offering cessation services at existing intersections with health care or integrating cessation support into mHealth and other alternative models of care
Combined prevalence of impaired glucose level or diabetes and its correlates in Lusaka urban district, Zambia: a population based survey
No full textCombined prevalence of impaired glucose level or diabetes and its correlates in Lusaka urban district, Zambia: a population based survey
No full textFirst report on the use of PRA approaches to realign power and use of power between community representatives and health workers for better primary health care in Zambia : equity gauge Zambia, phase 2; 1st national TOT workshop, 2-7 Oct. 2006
No full textSome figures missingPrevious studies consistently show popular participation structures in health to be either low or absent at most health facilities. Work done as part of this phase of activities of Equity Gauge Zambia indicate that an underlying cause of poor performance is the disproportionate distribution and use of power at district levels, in implementation of primary health care activities. This report outlines how workshop activities were undertaken, the reflection and consensus participants reached. The sessions and exercises that aim at empowering stakeholders to facilitate participatory processes are contained in the manual that was produced for this workshop
Prevalence of hypertension and its correlates in Lusaka urban district of Zambia: a population based survey
Get PDFBackground
Hypertension is a leading cause for ill-health, premature mortality and disability. The objective of the study was to determine the prevalence and associated factors for hypertension in Lusaka, Zambia. Methods
A cross sectional study was conducted. Odds ratios and their 95% confidence intervals were calculated to assess relationships between hypertension and explanatory variables. Results
A total of 1928 individuals participated in the survey, of which 33.0% were males. About a third of the respondents had attained secondary level education (35.8%), and 20.6% of males and 48.6% of females were overweight or obese. The prevalence for hypertension was 34.8% (38.0% of males and 33.3% of females). In multivariate analysis, factors independently associated with hypertension were: age, sex, body mass index, alcohol consumption, sedentary lifestyle, and fasting blood glucose level. Conclusions
Health education and structural interventions to promote healthier lifestyles should be encouraged taking into account the observed associations of the modifiable risk factors
