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ABSTRACT:-Background:Candida species have emerged as successful pathogens worldwide and are associated with immunocompromised patients. Additionally, there is increasing resistance of Candida species to antifungal agents, and this has greatly contributed to the high morbidity and mortality amongst affected patients. In Zambia, little is known about the distribution of Candida species and their antifungal susceptibility patterns. Speciation of Candida species is important as knowledge of the infecting species is important for guiding therapy. The objective of this study was, therefore, to characterise Candida species isolated from different clinical specimens at the University Teaching Hospital in Lusaka. Methods:This was a cross-sectional study involving the identification of 96 Candidaspecies from various clinical specimens, and determination of their antifungal susceptibility patterns. Identification of the isolates was achieved by the use of the API 20C AUX kit, followed by DNA sequencing of the Internal Transcribed Spacer region of the ribosomal DNA, whilst the agar-based E-test, using fluconazole, amphotericin B, flucytosine, and caspofungin, was used for antifungal susceptibility testing. Results: Data obtained showed that Candida albicans were the predominant species (66.7%), followed by C. lusitaniae (12.2%), C. glabrata (6.7%), C. tropicalis (5.6%), C. parapsilosis (3.3%), C. quilliermondii (3.3%), C.pelliculosa (1.1%) and C. keyr (1.1%). Most of the Candida species exhibited high levels of resistance to fluconazole and amphotericin B, but were sensitive to caspofungin and flucytosine. C. albicans was resistant to fluconazole (18.3%,) with an MIC 90 of 256µg/ml and amphotericin B (10%) with MIC 90 of 1.5µg/ml. C. glabrata was the most resistant species against amphotericin B (66.6%) with an MIC 90 of 2µg/ml.C. albicans and most of the non-albicans species exhibited multi-drug resistance. Conclusion: This study demonstrated that identification of Candida species to species level and susceptibility testing are important for accurate treatment of Candida infections.

The incidence and prevalence of liver tumours has increased globally over the past decades. This increase in liver tumours has led to an increase in morbidity and mortality. Phenotypic characterisation of liver tumours is important as it helps in planning for targeted management of diagnosed liver tumours. The aim of this study was to investigate the phenotypic distribution of primary and secondary liver tumours diagnosed at the University Teaching Hospitals in Lusaka, Zambia. Materials/Methods: This was a retrospective cross-sectional study that was conducted on 34 formalin-fixed paraffin embeddedliver tissue blocks at the University Teaching Hospitals. These archived liver tissues were isolated from 2012 to 2015. Tissues were cut for histological analysis using a microtome. Haematoxylin and Eosin staining were done on the slides to confirm hepatic tumour status. Data was analysed using Statistical Package Social Sciences version 20.0. Fisher's exact test was used to determine the association between variables. Statistical significance was conducted at 95% confidence interval with a p<0.05that indicate statistical significance. Results:From the examined 34 cases, the patient age distribution of liver tumours was as follows; <10 years (8.8%), 10-20 years (8.8%), 21-30 years (20.6%), 31-40 years (14.7%), 41-50 years (14.7%), 51-60 years (17.6%), 61-70 years (11.8%), and >70 years (2.9%). Liver tumours affect more males 19/34 (55.88%) than females 15/34 (44.12%). The male to female ratio of patients diagnosed with liver tumours was found to be 1.3:1 and p=0.03. The histological phenotypes of liver tumours recorded in this study included 17/34 (50%) hepatocellular carcinomas, 6/34 (17.6%) metastatic adenocarcinomas, 4/34 (11.8%) intrahepatic cholangiocarcinomas, 3/34 (8.8%) hepatoblastomas, 2/34 (5.9%) metastatic small cell carcinomas, and 2/34 (5.9 %) hepatic adenomas. There was a statistical significance between primary and secondary liver tumours as was evidenced by a p=0.04. Conclusion: Liver tumours affect patients mostly in the age group of 21-30 years. The study further reported that liver tumours affect more males than females. Furthermore, hepatocellular carcinoma, a primary liver tumouristhe most common histologically diagnosed liver tumour at the University Teaching Hospitals followed by metastatic adenocarcinomas.

Background: Zinc, copper and selenium are known important trace elements playing a vital role as cofactors of enzymes such as superoxide dismutase and glutathione peroxide. They form part of the first line antioxidants enzymes in red blood cells and plasma. The study aimed at determining the serum levels of zinc, copper and selenium in asymptomatic sickle-cell anaemia patients. Methods: This was a case control study conducted from the specialist Haematology and Oncology Clinic 4 at the University Teaching Hospital, Lusaka, Zambia. 5mls of whole blood was collected from 46 sickle-cell anaemia patients and 46 healthy controls from Out-Patient Department after consent. Using Atomic Absorption Spectrometry, serum levels of zinc, copper and selenium was determined. Independent t-test was used to compare the means and a binary logistic regression for the likelihood of developing a sickling crisis, using SPSS version 20.Results: The mean serum levels of zinc in patients were lower 86.92±20.46mg/L against 91.33±43.23mg/L; p<0.028 of controls. Copper mean levels were 149.85±54.82mg/L against 134.32±54.16mg/L; p<0.191 of controls. Selenium mean levels were 0.100±0.041mg/L against 0.081±0.032mg/L; p<0.380 in patients compared to controls. The odds of developing one sickling crises in the past year given the levels of zinc, copper and selenium was [B = -.340, zinc Exp(B) =1.011, copper Exp(B) = 1.008, selenium Exp(B) = .000, DF = 1].Conclusion: Zinc is reduced in sickle-cell anaemia patients. The probability of developing a sickling crisis is lower in patients with higher serum levels of zinc and copper by 1.1% and 0.8% respectively.