Review of the malaria epidemiology and trends in Zambia

A comprehensive desk review of malaria trends was conducted between 2000-2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria control.This review considered data from the National Health Information Management System,Malaria Surveys and Programme Review reports and analyzed malaria in-patient cases and deaths in relation to intervention coverage for all ages.Data showed three distinct epidemiological strata after a notable malaria reduction(66%)in in-patient cases and deaths,particularly between 2000-2008.These changes occurred following the(re-)introduction and expansion of indoor residual spraying up to 90%coverage,scale-up of coverage of long-lasting insecticidetreated nets in household from 50%to 70%,and artemisin-based combination therapy nationwide.However,malaria cases and deaths re-surged,increasing in 2009-2010 in the northern-eastern parts of Zambia.Delays in the disbursement of funds affected the implementation of interventions,which resulted in resurgence of cases and deaths.In spite of a decline in malaria disease burden over the past decade in Zambia,a reversal in impact is notable in the year 2009-2010,signifying that control gains are fragile and must be sustained toeliminate malaria.

Prevalence of HIV and Associated Factors among Infants Born to HIV Positive Women in Amhara Region, Ethiopia

Background: An estimated 1.2 percent of pregnant women are living with HIV in Ethiopia and sadly, one of every 3 children born to these women is infected with HIV. Elimination of these mother-to-child transmissions (MTCT) of HIV is possible through HIV testing during pregnancy and taking antiretroviral medications. However, only 24 percent of pregnant women living with HIV have yet received the medication needed to prevent MTCT of HIV in Amhara region, Ethiopia. Hence, there exists a concern that the rate of HIV infection among infants born to HIV positive mothers might be high. This study assessed the prevalence of HIV infection and associated factors among infants born to women living with HIV. Methods: All eligible records of HIV-exposed infants enrolled between January and December 2012 were reviewed from 17 health facilities which were providing PMTCT services. The study included 434 HIV-exposed infants having HIV DNA/PCR test result. Data were collected using structured data extraction formats. Data were then entered into EPI INFO Version 3.5.1 and analyzed by SPSS Version 16.0. Both bivariate and multivariate analyses were carried out to calculate odds ratios and to control for the effect of confounding. Result: The prevalence of HIV among exposed infants was 10.1%. Delay in HIV diagnosis (AOR = 1.3), mixed infant feeding (AOR = 8.8), failure to receive antiretroviral therapy during pregnancy or breast feeding (AOR = 21.6), failure to attend skilled delivery service (AOR = 6.1) and shorter duration of HIV treatment (AOR = 12) were the factors that increase the risk of mother-to-child transmission of HIV in this study. Conclusion: The prevalence of HIV among infants born to HIV positive women in the region is close to the national estimate of 10.9%. Delayed HIV diagnosis, inadequate use of antiretroviral therapy and lack of skilled delivery care were the factors that enhance mother-to-child transmission of HIV. Having such a significant figure in the era of the world’s pledge to eliminate MTCT of HIV is unbearable. Ensuring access and use of integrated PMTCT services should be the top priorities of the national PMTCT program.

A One Health approach to fight antimicrobial resistance in Uganda: Implementation experience, results, and lessons learned

Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations Capacities.The country remains prone to outbreaks,with more than 2o disease outbreaks reported in the past five years,including Ebola virus disease,Crimean-Congo haemorrhagic fever,Marburg haemorrhagic fever,measles,yel-low fever,coronavirus disease 2019(COVID-19),and cholera.Antimicrobial resistance(AMR)is an ongoing challenge.Uganda scored capacity level 3 on infection prevention and control(IPC)and antimicrobial steward-ship(AMS)in the 2017 Joint External Evaluation(JEE)assessment.Identified gaps were being addressed after a self-assessment in 2021.This paper describes the technical assistance approaches provided to Uganda by the Medicines,Technologies,and Pharmaceutical Services Program,funded by the United States(U.S.)Agency for International Development,and implemented by Management Sciences for Health.The program,through a One Health approach,supported systematic capacity strengthening based on the JEE's capacity advancement framework for global health security,specifically relating to AMR.The program's interventions impacted 32 WHO benchmark actions(7 for AMR multisectoral coordination,16 for IPC,and 9 for AMS),contributing to Uganda's strengthened GHSA capacity.Leveraging success built on the AMR platform,the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC teams.The program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions,covering 45 districts and reaching 5,452 health workers at 858 health facilities.2024 Chinese Medical Association Publishing House.Published by Elsevier BV.

Multidrug resistant Escherichia coli strains isolated from urine sample,University of Gondar Hospital,Northwest Ethiopia

Objective:To assess multidrug resistant(MDR)Escherichia coli(E.coli)isolates from patients with urinary tract infection.Methods:From February to June 2014,a cross sectional study was conducted among urinary tract infection patients at the University of Gondar Hospital.Culture and disk diffusion method were used for E.coli isolation and to determine the antibiotic susceptibility patterns.Data were entered and analyzed using SPSS version 20.P<0.05 was considered as statistically significant.Results:A total of 112 E.coli isolates were identified and the rate of isolation was higher among female participants(28.7%;P=0.03).Of the isolates,104(92.9%)were MDR E.coli;and the isolates showed high resistance rates towards ampicillin(99%),cotrimoxazole(69%),chloramphenicol(58.7%),gentamycin(56.7%)and ceftazidime(55.8%).However,comparative isolates showed low resistance rates to ciprofloxacin(1%),cefepime(8.7%),and ceftriaxone(11.5%).Moreover,resistance rates of MDR E.coli isolates were significantly higher than non-MDR strains for ceftazidime(55.8%versus 12.5%;P=0.015),and ampicillin(99%versus 87.5%;P=0.018).Conclusions:High prevalence of MDR E.coli isolates was observed in this study.Regular monitoring of antibiotic resistance rates is necessarily required to improve and revise empirical antibiotic therapy protocols.