Increased uptake of intermittent preventive treatment for malaria in pregnant women in Zambia(2006–2012):Potential determinants and highlight of lessons learnt

Objective:To assess potential determinants of uptake and highlight lessons learnt from the implementation of intermittent preventive treatment(IPTp), given to pregnant women as early as possible during the second trimester in Zambia.Methods: Data from four national malaria surveys(2006, 2008, 2010, 2012) were reviewed, and proportions of pregnant women attending antenatal clinics(ANCs) who received two or more doses of sulfadoxine–pyrimethamine(IPTp2) were compared by place of residence, education level, and wealth status. Malaria cases and deaths in pregnant women, from Health Information Management System 2011–2013, were analyzed to determine malaria burden in pregnancy in Zambia. A multiple logistic regression model was applied to identify potential determinants of IPTp uptake.Results: The proportion of pregnant women who took IPTp at ANCs increased from near zero at inception in 2001 to 61.9% in 2006; and to 72% by 2012(P < 0.001), and overall the uptake was 1.41 times higher in 2012 compared to 2006. From 2006 to 2012,IPTp2 uptake among women with no formal education increased from 51% to 68%(P < 0.1). Likewise, uptake among pregnant women with the lowest wealth index increased from 58.2% to 61.2%. By 2012, IPTp uptake among pregnant women within the lowest wealth index increased to a similar level as the women with high wealth index(P = 0.05). Incidence of malaria cases, hospital admissions and mortality during pregnancy decreased between 2011 and 2013. Overall, increased IPTp uptake was associated with being in urban areas(OR = 1.56, 95% CI: 1.39–1.74), having college(OR = 1.83,95% CI: 1.25–2.75) or secondary education(OR = 1.68, 95% CI: 1.44–1.96) or of being of higher wealth status(OR = 1.86, 95% CI: 1.60–2.17).Conclusions: Zambia has increased IPTp uptake through ANC for all women. The malaria control program has contributed to increasing access to health services and reducing demographic and socioeconomic disparities.

Prevalence and predictors of smoking in a mining town in Kitwe, Zambia: A 2011 population-based survey

Smoking is one of the major preventable causes of death and non-communicable diseases which include hypertension, cardiovascular diseases and cancers. The aim of the study is to establish prevalence and predictors of smoking so that interventions specific to these communities can be executed to prevent smoking. A cross sectional study was conducted using a modified World Health Organizations Global Non Communicable Diseases (NCD) Surveillance Initiative NCD-STEPs 1 and 2. Multivariate logistic regression was used to examine the determinants of tobacco smoking. A total of 1627 individuals participated in the survey, of which 42.3% were males. About half of the participants were of age 25-34 years (56.0%), and 41.7% had attained secondary level of education. Overall, 8.7% of the participants (18.1% among males and 1.8% among females) currently smoked any tobacco product. Female respondents were 71% (AOR = 0.29, 95%CI [0.21, 0.39]) less likely to smoke cigarettes compared to male respondents. Compared to respondents who had no formal education, respondents who had attained primary level of education were 45% (AOR = 1.45, 95%CI [1.02, 2.08]) more likely to smoke, and those who attained college or university level of education were 57% (AOR = 0.43, 95%CI [0.28, 0.65]) less likely to smoke. Respondents who did not consume alcohol were 50% (AOR = 0.50, 95%CI [0.41, 0.61]) less likely to smoke compared to those who consumed alcohol. The study showed that sex, education, and alcohol consumption were independently associated with Smoking. These are the key determinants which should be considered when designing a health education and awareness campaign to the residents.