BackgroundIn line with the Global trend to improve malaria control efforts a major campaign of insecticide treated net distribution was initiated in 1999 and indoor residual spraying with DDT or pyrethroids was reintroduced in 2000 in Zambia. In 2006, these efforts were strengthened by the President's Malaria Initiative. This manuscript reports on the monitoring and evaluation of these activities and the potential impact of emerging insecticide resistance on disease transmission.MethodsMosquitoes were captured daily through a series of 108 window exit traps located at 18 sentinel sites. Specimens were identified to species and analyzed for sporozoites. Adult Anopheles mosquitoes were collected resting indoors and larva collected in breeding sites were reared to F1 and F0 generations in the lab and tested for insecticide resistance following the standard WHO susceptibility assay protocol. Annual cross sectional household parasite surveys were carried out to monitor the impact of the control programme on prevalence of Plasmodium falciparum in children aged 1 to 14 years.ResultsA total of 619 Anopheles gambiae s.l. and 228 Anopheles funestus s.l. were captured from window exit traps throughout the period, of which 203 were An. gambiae malaria vectors and 14 An. funestus s.s.. In 2010 resistance to DDT and the pyrethroids deltamethrin, lambda-cyhalothrin and permethrin was detected in both An. gambiae s.s. and An. funestus s.s.. No sporozoites were detected in either species. Prevalence of P. falciparum in the sentinel sites remained below 10% throughout the study period.ConclusionBoth An. gambiae s.s. and An. funestus s.s. were controlled effectively with the ITN and IRS programme in Zambia, maintaining a reduced disease transmission and burden. However, the discovery of DDT and pyrethroid resistance in the country threatens the sustainability of the vector control programme.

Abstract

Background

The Zambian Malaria Control Programme with the Roll Back Malaria (RBM) partners have developed the current National Malaria Strategic Plan (NMSP 2006–2011) which focuses on prevention based on the Integrated Vector Management (IVM) strategy. The introduction and implementation of an IVM strategy was planned in accordance with the World Health Organization (WHO) steps towards IVM implementation namely Introduction Phase, Consolidation Phase and Expansion Phase.

Achievements

IVM has created commitment for Legal and Regulatory policy review, monitoring, Research and a strong stewardship by the chemical suppliers. It has also leveraged additional resources, improved inter-sectoral collaboration, capacity building and enhanced community participation which facilitated a steady scaling up in coverage and utilisation of key preventive interventions. Thus, markedly reducing malaria incidence and case fatalities in the country.

Conclusion

Zambia has successfully introduced, consolidated and expanded IVM activities. Resulting in increased coverage and utilization of interventions and markedly reducing malaria-related morbidity and mortality while ensuring a better protection of the environment.

BackgroundAdolescent pregnancy is among the many public health concerns not only in Zambia but also in other parts of the world. Exploring pregnant adolescents’ experiences of antenatal care may help to identify specific problems and the contextual relevant strategies to improve the access to antenatal care. The purpose of this study was to explore and describe the lived experiences of antenatal care among pregnant adolescents aged between 12 to 19 years old at Kanyama and Matero Referral Clinics in Lusaka district of Zambia.MethodsThis was a qualitative study which used in-depth interviews to collect data. Maximum variation sampling technique was used to select 12 pregnant adolescents of 12 to 19 years age range that attended antenatal care. Data were analysed thematically with the help of Nvivo software version 10.ResultsThe study revealed that the adolescents experienced positive and negative antenatal care. While there were some reported cases of caring and friendly health care providers and older pregnant women, there were also reported cases of poor attitudes and behaviours by the older pregnant women and health care providers towards the adolescents. In addition, other issues that were reported by the adolescents were the opening hours for the health facilities which was not favourable to all adolescents and the lack of specific spaces for adolescents as well as inadequate privacy and confidentiality. Some solutions were suggested to overcome some of the problems such as reducing the waiting hours or time for consultations at the clinic and to have specific rooms or spaces for pregnant adolescents at the clinic.ConclusionAppropriate interventions targeting pregnant adolescents with emphasis on making antenatal care services more adolescent friendly may improve the quality of and accessibility of antenatal services. The adolescent friendly antenatal services should integrate health promotion activities aimed at sensitising elderly women within the health facilities on the importance of supporting pregnant adolescents.

No abstract

In four crowded townships of Lusaka, Zambia, the prevalence of cryptosporidiosis in 222 children with diarrhea was 18%, with marked temporal and geographic variation over the course of one rainy season. Using data on the finding of oocysts of Cryptosporidium parvum in urban water supplies, the areas under study were categorized as high or low risk. Prevalence of cryptosporidiosis in children with diarrhea was higher in high risk areas after stratification by early/late stage of the rains (Mantel-Haenszel odds ratio [OR] ϭ 2.9, 95% confidence interval [CI] ϭ 1.3, 6.7; P ϭ 0.008). Cryptosporidiosis was not associated with keeping animals, nutritional status, or parental education, but was apparently more common in breast fed children (OR ϭ 2.7, 95% CI ϭ 1.1, 6.9; P ϭ 0.01), although the proportion of exclusively breast fed children was not measured. Since most of these infections were of short duration, we conclude that transmission of C. parvum can vary dynamically within one city and over short periods of time, and that water-borne contamination may be a substantial influence.