The socio-economic impact of stroke on households in Livingstone district, Zambia- a cross sectional study

The World Health Organization (WHO) defines stroke as 'the neurological deficit of cerebral vascular cause that persists beyond twenty four hours or is interrupted by death within 24 hours'. In Livingstone, Zambia, more than 30% of stroke victims indicate socio-economic problems. The study aimed at assessing the socioeconomic impact of stroke in households in Livingstone district. A total of 50 households were conveniently selected from the Physiotherapy and Community Based Rehabilitation registers of Livingstone General Hospital. Self administered questionnaires and Focus group discussions were used to collect quantitative and qualitative data respectively. The data was analyzed using SPSS and content analysis. The social impacts on the victim were depression, difficult to get along with, resentfulness, apathy, needy, separation, divorce, general marital problems, neglect on the part of the victim and fear. In families, there was low moods and apathy in households. The study also revealed an association between period of stroke and relationship changes (p<0.001). Gender and family relationship changes were highly associated (p<0.001), as more females than males experienced relationship changes. The economic impacts were loss of employment, reduced business activity and loss of business on the part of the victim. Economic activities like food provision, payment of school fees, accommodation were affected as a result of stroke, and this led to financial insecurities in households. The study also showed that the incomes lost were mostly salaries, followed by businesses. Most of the victims experienced economic challenges after stroke with a few of them were receiving economic assistance. The activities forgone by stroke households were food provision, housing, and education in order to accommodate the stroke situation in the households. The results of the study show that stroke has considerable socioeconomic impact on households which can deter the victims' developmentKeywords: Stroke; household; socio-economic; impact; Livingston

Work-related Musculoskeletal Disorders: Prevalence, contributing factors and coping strategies among Physiotherapy personnel in Lusaka, Kitwe and Ndola districts, Zambia

Background: Injuries at a work place comprise a substantial part of injury burden. Work-related musculoskeletal disorders (WRMDs) are common in the field of physiotherapy because the nature of job tasks is physically challenging and therapeutic procedures are often repetitive, labour intensive and involve direct contact with patients. The objective of the study was to determine the prevalence, contributing factors and coping strategies for WRMDs among physiotherapy personnel in Lusaka, Kitwe and Ndola districts of Zambia.Methods: Data was collected using a selfadministered semi structured questionnaire in a cross sectional study. Data were summarized using percents for categorical variables, mean (standard deviation) for continuous variables, and median (Q1, Q3) for skewed variables.Results: A total of 120 physiotherapists participated in the survey and of these 82 (68.3%) experienced WRMDs that lasted for more than 3 days in the previous 12 months to the survey. Most (40.7%) participants experienced work-related injuries within the first five years after graduation. The majority of the participants indicated that the following work factors contributed to WRMDs: treating a large number of patients per day (97.5%), repeatedly performing the same task (94.9%), performing manual therapy techniques (93.2%), working in the same position for long periods (92.1%), and lifting and transferring patients (88.6%).Conclusions: WRMDs are common among physiotherapy personnel in Lusaka, Kitwe and Ndola districts of Zambia. Outcomes underlines the importance of further research with larger sample sizes to examine factors associated with WRMDs among physiotherapy personnel in this country.&#160

Alcohol Consumption and its Correlates Among Residents of Mining Town, Kitwe, Zambia: 2011 Population Based Survey

Alcohol consumption is a risk factor for non-communicable diseases such as cardiovascular diseases, liver cirrhosis and cancers. It has also been associated with risky sexual behaviors, hence, attributed as a factor in the increase of HIV incidence and prevalence. A cross sectional study was conducted using a modified World Health Organizations Global Non Communicable Diseases (NCD) Surveillance Initiative NCD-STEPs 1and 2. Multivariate logistic regression was used to examine the determinants of alcohol consumption. A total of 1627 individuals participated in the survey, of which 42.3% were males. Some 22.3% (36.2% of male and 12.1% of female; p\u3c0.001) participants reported to have consumed alcohol during the 30 days preceding the survey. The factors considered to be associated with alcohol consumption were age, sex and smoking. Compared to respondents age 25-34 years, respondents of age 35-44 years were 38% (AOR = 1.38, 95%CI [1.11, 1.70]) more likely to report having consumed alcohol and those aged 45 years or older were 26% (AOR = 0.74, 95%CI [0.60, 0.93]) less likely to report having consumed alcohol. Female respondents were 47% (AOR = 0.53, 95%CI [0.46, 0.60]) less likely to report consuming alcohol compared to male respondents. Compared to respondents who reported smoking cigarettes, those who did not smoke cigarettes were 51% (AOR = 0.49, 95%CI [0.40, 0.59]) less likely to consume alcohol. The rate of alcohol consumption is high in this mining town. Factors identified in this study as associated with alcohol consumption, i.e., male sex, age, cigarette smoking, should be considered in designing interventions to curtail the level of alcohol consumption

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

Prevalence and Determinants for Overweight and Obesity among Residents of a Mining Township in Kitwe, Zambia, in 2011: A population-based Survey

Background: Obesity and overweight in Africa have been attributed to demogra- phic and nutritional changes that have resulted from urbanization and sedentary lifestyles and increased caloric intake without much physical activities. This has put populations at an increased risk of cardiovascular diseases, Diabetes mellitus, osteoarthritis, dyslipidemia, and cancer. The objective of this study was to deter- mine the prevalence and associated factors for combined overweight and obesity among residents of a mining town, Kitwe, in Zambia. Methods: A cross sectional study was conducted using a modified WHO glo- bal Non Communicable Diseases Surveillance Initiative STEPs 1 and 2 method of data collection. Proportions of study participants (25 years or older) who were overweight or obese were calculated. Logistic regression analyses were performed to determine associations between selected exposure variables and overweight/ obesity. Findings: 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. The prevalence of overweight and obesity was 24.7% (21.0% among males and 27.3% among females, p=0.005) and 16.9% (8.0% among males and 23.5% among females, p\u3c0.001), respectively. In multivariate analysis, age, sex, education level, sedentary lifestyle, smoking and blood pressure were significantly associated with overweight and obesity. Conclusions: Healthy living through an intensive, comprehensive public health education and sensitization should be promoted in terms of regular exercises

Prevalence of hypertension and its correlates in Lusaka urban district of Zambia: a population based survey

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>A cross sectional study was conducted. Odds ratios and their 95% confidence intervals were calculated to assess relationships between hypertension and explanatory variables.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>Health education and structural interventions to promote healthier lifestyles should be encouraged taking into account the observed associations of the modifiable risk factors.</p

Targeting condom distribution at high risk places increases condom utilization-evidence from an intervention study in Livingstone, Zambia

Background: The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. Methods: The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Results: Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up). There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84%) than in the control community (55% to 68%). Conclusions: It is likely that the substantial increase in reported condom use in the intervention venues was partially due to the condom distribution and peer education intervention targeting these places. However, substantial changes were observed also in the comparison community over the five year period, and this indicates that major changes had occurred in overall risk taking among people socializing in venues where people meet new sexual partners in Livingstone

Health status and socio-economic factors associated with health facility utilization in rural and urban areas in Zambia

Background: With regards to equity, the objective for health care systems is “equal access for equal needs”. We examined associations of predisposing, enabling and need factors with health facility utilization in areas with high HIV prevalence and few people being aware of their HIV status. Methods: The data is from a population-based survey among adults aged 15years or older conducted in 2003. The current study is based on a subset of this data of adults 15–49 years with a valid HIV test result. A modified Health behaviour model guided our analytical approach. We report unadjusted and adjusted odds ratios and their 95% confidence intervals from logistic regression analyses. Results: Totals of 1042 males and 1547 females in urban areas, and 822 males and 1055 females in rural areas were included in the study. Overall, 53.1% of urban and 56.8% of rural respondents utilized health facilities past 12 months. In urban areas, significantly more females than males utilized health facilities (OR=1.4 (95% CI [1.1, 1.6]). Higher educational attainment (10+ years of schooling) was associated with utilization of health facilities in both urban (OR=1.7, 95% CI [1.3, 2.1]) and rural (OR=1.4, 95% CI [1.0, 2.0]) areas compared to respondents who attained up to 7 years of schooling. Respondents who self-rated their health status as very poor/ poor/fair were twice more likely to utilize health facilities compared to those who rated their health as good/excellent. Respondents who reported illnesses were about three times more likely to utilize health facilities compared to those who did not report the illnesses. In urban areas, respondents who had mental distress were 1.7 times more likely to utilize health facilities compare to those who had no mental distress. Compared to respondents who were HIV negative, respondents who were HIV positive were 1.3 times more likely to utilize health facilities. Conclusion: The health care needs were the factors most strongly associated with health care seeking. After accounting for need differentials, health care seeking differed modestly by urban and rural residence, was somewhat skewed towards women, and increased substantially with socioeconomic position

Health status and socio-economic factors associated with health facility utilization in rural and urban areas in Zambia

Abstracts Background With regards to equity, the objective for health care systems is “equal access for equal needs”. We examined associations of predisposing, enabling and need factors with health facility utilization in areas with high HIV prevalence and few people being aware of their HIV status. Methods The data is from a population-based survey among adults aged 15years or older conducted in 2003. The current study is based on a subset of this data of adults 15–49 years with a valid HIV test result. A modified Health behaviour model guided our analytical approach. We report unadjusted and adjusted odds ratios and their 95% confidence intervals from logistic regression analyses. Results Totals of 1042 males and 1547 females in urban areas, and 822 males and 1055 females in rural areas were included in the study. Overall, 53.1% of urban and 56.8% of rural respondents utilized health facilities past 12 months. In urban areas, significantly more females than males utilized health facilities (OR=1.4 (95% CI [1.1, 1.6]). Higher educational attainment (10+ years of schooling) was associated with utilization of health facilities in both urban (OR=1.7, 95% CI [1.3, 2.1]) and rural (OR=1.4, 95% CI [1.0, 2.0]) areas compared to respondents who attained up to 7 years of schooling. Respondents who self-rated their health status as very poor/ poor/fair were twice more likely to utilize health facilities compared to those who rated their health as good/excellent. Respondents who reported illnesses were about three times more likely to utilize health facilities compared to those who did not report the illnesses. In urban areas, respondents who had mental distress were 1.7 times more likely to utilize health facilities compare to those who had no mental distress. Compared to respondents who were HIV negative, respondents who were HIV positive were 1.3 times more likely to utilize health facilities. Conclusion The health care needs were the factors most strongly associated with health care seeking. After accounting for need differentials, health care seeking differed modestly by urban and rural residence, was somewhat skewed towards women, and increased substantially with socioeconomic position.</p

Targeting condom distribution at high risk places increases condom utilization-evidence from an intervention study in Livingstone, Zambia

Abstract Background The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. Methods The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Results Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up). There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84%) than in the control community (55% to 68%). Conclusions It is likely that the substantial increase in reported condom use in the intervention venues was partially due to the condom distribution and peer education intervention targeting these places. However, substantial changes were observed also in the comparison community over the five year period, and this indicates that major changes had occurred in overall risk taking among people socializing in venues where people meet new sexual partners in Livingstone. Trial registration ClinicalTrials.gov NCT01423357.</p