New Grant: Elton John AIDS Foundation Awards CIDRZ a £750,000 Grant

CIDRZ receives a Two and half year grant from Elton John Foundation for Building capacities of the Zambia Correctional Service to provide holistic and integrated health services to juvenile offenders.

The Elton John Foundation has awarded CIDRZ a £750,000 to provide comprehensive, juvenile-appropriate health services including recreational and legal services.

The grant will focus on incarcerated juveniles owing to their vulnerability, marginalisation and increased risk of sexual exploitation and discrimination, hence, increased risk of HIV infection especially those incarcerated in adult holding facilities..

This grant will provide comprehensive interventions tailored to the needs of incarcerated juveniles aimed at reducing risk of HIV and other STI infections subsequently morbidity and mortality due to HIV and TB, and improve the quality of life of incarcerated juveniles.

In addition, the grant will initiate adolescent friendly health and social services, support legal services and advocate for judicial reform to expedite case disposal thereby reducing time of detention without trail.

For more information on this project, you can contact  the Principal Investigateor, Dr Monde Muyoyeta, CIDRZ Director of TB programme (; or Clement Moonga, the Programme Manager (

CIDRZ calls for assessment of the duration of protection of One-dose cholera vaccine

 [CAPE TOWN] A dose of oral vaccine provides effective short-term protection against the cholera during an outbreak, a study in Zambia shows.

According to researchers, because of a shortage of global stockpile of cholera vaccines, an outbreak in Lusaka, Zambia, in February 2016 necessitated a need for single-dose vaccination.

An emergency single-dose oral vaccination campaign was implemented in April 2016, around Lusaka, targeting more than 500,000 people in the city’s overcrowded township areas.

Francisco Luquero, a co-author of the study and an expert in preventable diseases at the France-based Epicentre, the research arm of the Médecins Sans Frontières (MSF) or Doctors without Borders, says that studies have already proved that one oral cholera vaccine dose works, but they were conducted in countries that had recently experienced cholera.

The 2016 outbreak happened when Zambia had not reported a case of cholera in four years.

“Our results show that people vaccinated can be protected against cholera a few days after receiving one dose.”

Francisco Luquero, Médecins Sans Frontières (MSF)

Between 25 April 2016 and 15 June 2016, researchers enrolled 66 patients with confirmed cholera and 330 people without the disease but who were neighbours of the patients, and determined the effectiveness of the single-dose cholera vaccine.

According to the study published last month (8 February) in the New England Journal of Medicine, the effectiveness of the single dose vaccination was about 90 per cent.

“Our results show that people vaccinated can be protected against cholera a few days after receiving one dose, which is important in outbreaks because we need to protect people quickly, Luquero says.

Oral cholera vaccines are emerging as a new tool for cholera control and have been used in past years to successfully prevent outbreaks in complex emergencies, to curb cholera epidemics or to reduce burden in countries which are endemic but there is a current global shortage, MSF says.

The Lusaka outbreak ended quickly after the implementation of the vaccination campaign, thus limiting the number of cases recruited, Luquero explains.

The Ministry of Health offered a second vaccine eight months later in December 2016.

The WHO estimates that globally cholera infects one to four million people a year, resulting in 21 000 to 143 000 deaths, with countries in Sub-Saharan Africa at increased risk.

“This is an important study because it suggests that the world could face the challenges of cholera outbreak with a single dose,” says Roma Chilengi, chief scientific officer, Centre for Infectious Disease Research in Zambia, adding a single-dose vaccine is cheaper and could help countries with limited financial ability to control the disease.

But Chilengi tells SciDev.Net, “It would be helpful to be clear about the potential duration of the protection the single dose offers.”

This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.


Eva Ferreras and others Single-dose cholera vaccine in response to an outbreak in Zambia(New England Journal of Medicine, 8 February 2018)

Original Article:

Breaking the Barriers: CIDRZ reaches to Nc’wala Ceremony Attendees with Health Messages

Nc’wala Ceremony attendees at the CIDRZ stand

To ensure that quality health care reaches to as many as possible in all the sites where CIDRZ has presence, working with the local leadership has been one of the strategies the organisation uses to reach out to many people with health information.

We engage with traditional leaders to discuss health issues that concern their people and we take advantage of every opportunity to do so. We talk about cervical cancer, Voluntary Medical Male Circumcision, Prevention of Mother to Child Transmission of HIV, Tuberculosis and best ways to link HIV positive people to care.

And we have always found positive attitude with our traditional leaders and have received support for our work.

This is why during this year’s Nc’wala ceremony, CIDRZ with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and partnership from the U.S Centers for Disease Control and Prevention (CDC) During this year’s ceremony, sensitised a total number of 2131 people voluntary male medical circumcision, condom use, Prevention of Mother to Child Transmission of HIV (PMTCT) and cervical cancer.

Messages on the importance of HIV testing, male circumcision for HIV negative partners and cervical cancer prevention and management were disseminated to individuals as well as groups of people. We conducted two onsite circumcision procedures.

CIDRZ also provided HIV testing services of which 578 people got tested with six people found HIV positive were linked to care.

Nc’wala Traditional Ceremony is an annual event of the Ngoni-Speaking People of Eastern Province and takes  at Mtenguleni in Chipata District, Eastern Province to celebrate the first harvests of the year.

Oral cholera vaccine (OCV) can save lives: Intensified efforts to eliminate cholera in Zambia

Prof David Sack, Dr Roma Chilengi, CIDRZ Chief Scientific Officer and other study staff with Volunteers from Lukanga Swamp who help with tracking DOVE study participants in the swamps and lagoons

Zambia is currently grappling with the fight against cholera. More than 3000 cases have been reported since the 2017/18 rain season begun and more than 70 deaths recorded. A multisectoral approach to combat the outbreak has been implemented including the use of security personnel to maintain public order and more than ZMW100 million (USD10m) has been spent so far.


The first outbreak of cholera in the country was recorded between 1977 followed by another outbreak in 1982; and since then, there has been outbreaks though, not on an annual basis. These outbreaks, once they occur, put the country under serious economic and health stress.

Several strategies on the prevention of cholera such as providing clean water and proper sanitation, health education and good food hygiene have been promoted as long term measures to prevent such outbreaks, however, the need to integrate oral cholera vaccines (OCV) to these strategies continues to be emphasised.

Professor David Sack, from the Department of International Health at Johns Hopkins Bloomberg School of Public Health shade more light on OCV during the CIDRZ research meeting when he made a presentation on ‘How can CIDRZ contribute to elimination of cholera in Zambia?’.

The World Health Organization (WHO) agrees “given the current availability of killed whole-cell OCVs and data on their safety, efficacy, field effectiveness, feasibility, impact and acceptability in cholera-affected populations, these vaccines should be used in areas with endemic cholera, in humanitarian crises with high risk of cholera, and during cholera outbreaks. The vaccines should always be used in conjunction with other cholera prevention and control strategies”.

Prof Sack reiterates that “sanitation is the long term solution; but vaccine will provide results more quickly. The first round of OCV in Zambia in April 2016 showed 89% effectiveness from 423,774 doses administered to a target population of 543,755 people. OCV reduces the risk for persons to receive vaccine, if coverage is high, OCV also reduces the risk for persons who do not receive vaccine and further reduces the risk for persons who receive the vaccine. Clearly vaccine is not an alternative to safe water; however, vaccine and improved water/sanitation actually work together—each reinforces the benefit of the other”.

He added that critical elements towards cholera elimination included understanding the disease burden (epidemiology, transmission, surveillance, seasonality, hotspots), an integrated national plan to focus efforts on Hotspots as well as resources and leadership.

Study participants fulfing their appointments with study staff from CIDRZ

CIDRZ is currently implementing the Delivering Oral Vaccine Effectively (DOVE) Project in collaboration with Johns Hopkins Bloomberg School of Public Health, a cholera vaccine study in the Lukanga Swamps. The goal of the DOVE project is to ensure that populations at risk of cholera will benefit from receiving OCV in an appropriate and effective manner.


The project provides tools and resources to countries and agencies who are dealing with the threat of cholera in order to assist them in making evidence-based decisions regarding when and how to use OCV.

HIV self-testing acceptable and accessible among female sex workers Zambian transit towns

Mbaita Shawa, during the Research Meeting at CIDRZ

HIV testing is essential for realizing the first step of UNAIDS 90:90:90 target by 2020 and its introduction was as an alternative to traditional testing to reach the UN target.

In Zambia, a study conducted by CIDRZ showed that HIV Self Testing was accepted in the general population but, little is known about its acceptability among female sex workers.
Mbaita Shawa, a CIDRZ HealthCorp Fellow conducted a review on article on “HIV self-testing among female sex workers in Zambia : a cluster randomized controlled trial” a study conducted to evaluate the effect of two different health system mechanisms for HIV self-test delivery compared to referral to standard HIV testing among transit town based female sex workers of Chirundu, Kapiri Mposhi and Livingstone.

Results from the study revealed that of the 965 participants, 885 (91.7%) returned to follow up at 1 month and 898 (93.1%) returned at 4 months, 92.3% and 89.5% reported use of HIV self -test in one (1) month and four (4) months respectively, and linkage to HIV services.

In her review, Mbaita concluded that in the short term, direct delivery self- testing may be more effective as it removed confidentiality and logistical barriers to accessing HIV services and that the modality was acceptable to female sex workers and can lead to uptake of HIV self- testing just as high as direct delivery.
“This study indicates that HIV testing interventions, delivered by peer educators may have a large effect on HIV testing”

She recommends that future long term studies consider linkage to care and Anti Retroviral Therapy interventions following HIV self -testing, the role of peer educators in facilitating HIV care cascade progression

Researchers Offer New Model for Uncovering True HIV Mortality Rates in Zambia: Accurate information needed to improve treatment outcomes

LUSAKA/WASHINGTON 12 Jan. 2018 A new study that seeks to better ascertain HIV mortality rates in Zambia could provide a model for improved national and regional surveillance approaches, and ultimately, more effective HIV treatment strategies.

Survival represents the most important indicator of successful HIV treatment, according to the researchers. According to UNAIDS, mortality from HIV has fallen by 50 percent since 2004—largely due to the successes of national HIV programs, PEPFAR, and the Global Fund. Yet, because routine monitoring and evaluation fails to systematically capture most deaths, it can be challenging to accurately assess the impact of HIV services and to identify where improvement is most needed, the researchers say.

The Better Information for Health in Zambia (“BetterInfo”) study begins to examine survival rates in Zambia. Published January 12 in PLOS Medicine, the work was conducted by a team of researchers co-led by Charles Holmes, MD, MPH, faculty co-director of Georgetown University Medical Center’s Center for Global Health and Quality, and visiting associate professor at Georgetown’s School of Medicine. Holmes led the work along with Izukanji Sikazwe, MBChB, MPH, Chief Executive Officer of the Centre for Infectious Research in Zambia (CIDRZ) and Elvin Geng, MD, MPH, of the University of California, San Francisco. Holmes, who previously led CIDRZ, also serves as associate professor of international health at Johns Hopkins Bloomberg School of Public Health and associate professor of medicine at Johns Hopkins School of Medicine.

The research was conducted in Zambia through a partnership with CIDRZ and the Zambian Ministry of Health, in close collaboration with numerous local and global academic centers and researchers.

The research group set out to provide a more accurate representation of site- and regional-level mortality among people on HIV therapy in Zambia by characterizing the extent of under-reporting of mortality and the variability in data collection and use, and to assess the broader impact this might have on treatment programs and outcomes.

The group applied a multistage sampling-based approach—which they say is a novel methodology in this context—to obtain regionally representative mortality estimates in four Zambian provinces (Lusaka, Southern, Eastern, and Western). The estimates were also sufficiently precise to quantify variation in death rates among clinic sites.

They looked at a sample population of more than 160,000 patients who had visited government-operated HIV treatment sites in these provinces to determine: the magnitude of deaths of those who were taking antiretroviral therapy (ART); when deaths occurred; which groups are at highest risk of death; and whether these factors differ by region, facility, or other variables.

They also traced patients who were lost to follow-up to ascertain their status, and then used this information to create a corrected regional survival estimate as well as corrected site-specific mortality estimates.

The BetterInfo study concluded that mortality is substantially underreported in routine provincial program data—by as much as three- to nine-fold—among HIV-infected individuals starting ART, leading to a change in the ranking of provinces by mortality rates.

At the site-level, “corrected” mortality rates were found to be up to 23-fold higher among those on ART. The study also found unexpectedly high variability from site to site in reported mortality rates, ranging from less than 1 death per 100 person-years to up to 13.4 deaths per 100 person-years over a two-year period.

“Even as we strive to reduce new HIV infections and end the HIV pandemic as a public health threat, we must not lose sight of premature deaths occurring amongst people living with HIV who are on treatment,” Holmes says. “HIV treatment is not a ‘set it and forget it’ proposition—deaths often occur outside of the health system and are therefore ‘silent’ events that are unknown to those providing or managing care.

“We believe our scalable approach, which builds on and extends earlier sampling methods, provides actionable data to clinic, provincial and national decision-makers to ensure the HIV program in Zambia is able to become more patient-centered and impactful,” he says.

Based on the findings, certain prevailing assumptions that underlie HIV programs may need to be reexamined. For example, the researchers say it has been assumed that most patients on treatment for longer periods of time will be more stable than those just starting treatment. However, the study data suggest that time on therapy alone may not be a reliable marker of stability, a finding that will have implications for delivery strategies recommending less health system interaction for patients considered clinically stable.

In addition, approximately 50% of deaths among those newly starting ART occurred relatively shortly after a recent clinic visit, suggesting even greater need for attention to diagnostic services and clinical vigilance for potential co-existing illnesses.

Overall, the authors seek to encourage national- and global-level policy makers to investigate and address the root causes of underestimated and highly variable mortality rates so they can refocus their quality improvement efforts and strengthen HIV programs.

“These data from the BetterInfo study have provided new targets for quality improvement efforts, and we look forward to further evidence as it emerges that will enable us to support the strongest possible national HIV program in Zambia,” says CIDRZ’s Sikazwe. “We recommend that others consider the application of similar large-scale surveillance methodologies in order to better understand their program outcomes, and we are excited to facilitate broader adoption through the forthcoming release of a “BetterInfo” toolkit and other materials.”

Holmes adds, “We believe our study also highlights the critical need for investments in vital status registries and data systems to enable better visibility into patient outcomes. These investments are critical not just for the HIV response, but for broader efforts to combat chronic conditions such non-communicable diseases and achieve universal health coverage.”

Additional co-authors of the study include Kombatende Sikombe, MPH, Njekwa Mukamba, Sandra Simbeza, MSc, and Cardinal Hantuba from CIDRZ; Ingrid Eshun-Wilson, MBChB, MSc, from Stellenbosch University in Cape Town, South Africa; Nancy Czaicki, PhD, MPH, from CIDRZ and University of California, Berkeley; Laura K. Beres, MPH, from Johns Hopkins University; Carolyn Bolton Moore, MBBCh, MSc, from CIDRZ and University of Alabama at Birmingham; Peter Mwaba, MBChB, PhD, from Lusaka Apex Medical University in Lusaka, Zambia; Caroline Phiri, MD, MPH, from the Ministry of Health, Government of the Republic of Zambia; Nancy Padian, PhD, MPH, from the University of California, Berkeley; and David V. Glidden, PhD, from the University of California, San Francisco.

The study was funded by the Bill & Melinda Gates Foundation (OPP1105071). The authors report having no personal interests related to the study.

“Estimated mortality on HIV treatment among active patients and patients lost to follow-up in 4 provinces of Zambia: Findings from a multistage sampling-based survey.”

About Georgetown University Medical Center
Georgetown University Medical Center (GUMC) is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis — or “care of the whole person.” The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization, which accounts for the majority of externally funded research at GUMC including a Clinical and Translational Science Award from the National Institutes of Health. Connect with GUMC on Facebook (, Twitter (@gumedcenter). Connect with Georgetown University School of Medicine on Facebook (, Twitter (gumedicine) and Instagram (@GeorgetownMedicine).

President Lungu Launches one year ‘Tiyende Pamodzi’ Campaign: reaching out to Everyone with HIV Information and treatment

CIDRZ staff participating in the World AIDS Day commemoration activities today

President Edgar Lungu today, 11 December 32017, launched the Lusaka Anti Retroviral Therapy Saturation Surge Campaign. He launched the campaign during the commemoration of the World AIDS Day celebrations, whose theme is Ënding AIDS Starts with ME!”.

President Lungu during the launch of the campaign at Nkoloma Stadium in Lusaka today

 “This is the first ever surge campaign in Africa and I would urge everyone to support this campaign by getting tested now. If you are found negative, live responsibly and if found positive start treatment now immediately,” President Lungu said.

In his launch speech, President Lungu said “the commemoration of World AIDS Day this year coincides with the launch of the Lusaka Ant-retroviral Therapy Surge Campaign dubbed ‘Tiyende Pamodzi’’ . This campaign is aimed at Achieving HIV epidemic control, within one year, in Lusaka which currently carries 25 percent of the national HIV burden.”

President Lungu said, though Zambia has witnessed the decline of HIV cases, more work need to be done to sustain the gains achieved so far.

What is Lusaka ART Saturation Surge campaign?

How are we fairing on 90:90:90 strategy in Lusaka

Lusaka ART Saturation Surge Campaign is a strategy by the Ministry of Health and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) in Zambia to achieve HIV epidemic control in Lusaka Province over 12 months, whereby 90% of People Living with HIV(PLHIV) are identified, 90% of identified PLHIV are placed on ART, 90% of PLHIV on ART become virally suppressed and use the information learned from achieving epidemic control in Lusaka Province to assure achieving 90-90-90 efficiently in Zambia nationwide by or before December 2020.

Currently, Lusaka province statistics indicate that out of an estimated population of 326,535 people living with HIV, only 71% of people are aware of their HIV status, while 88% are on treatment and 89% are virally suppressed.

CIDRZ, being the main GRZ partner in Lusaka will take a lead in ensuring that the objects, 90:90:90 are reached for Lusaka.


CIDRZ is ready for the challenge

The Surge Strategies

The campaign will implement strategies such as increasing targeted case identification through index testing of family and other sexual partners (Partner Notification Services), different linkage strategies tailored for health facilities and communities, Implement the WHO recommendation to retest for verification HIV positive individuals prior to ART initiation and HIV self-testing to reach adolescents, men, and key populations.

Another strategy will be to increase physical infrastructure and staffing to provide ART for increased number of patients by procuring and erecting pre-fabricated structures and hiring additional staff at selected clinics. Convert selected health posts to ART sites by providing the required staff, ARVs and other health commodities, equipment and furniture for service delivery.

Expanding Differentiated Service Delivery (DSD) is another strategy that will be used to better serve the needs of patients on ART and reduce the workload of healthcare workers. This will be achieved through transfer of all stable patients into DSD programs to reduce the time and effort that they need to spend to receive care and treatment, which in turn should improve retention. Provide multiple months prescriptions of ARVs and 6-monthly clinical consultations for all stable patients in Lusaka to reduce the number of clinic visits.

In order to achieve the 3rd 90, viral load testing will be increased to assure that there is capacity to determine the viral load for all patients on ART. Lusaka Province, currently has three viral load testing labs namely the University Teaching Hospital, Pediatric Center of Excellence, and CIDRZ Central Lab with a collective capacity to process 100,000 viral load tests annually.

Lastly, the storage space for ARVs at the district and site levels will be increased to assure adequate supply for the increased number of patients and multiple months prescription, carefully forecast the supply needs at the site level and inform central medical stores to ensure timely drug distribution and ensure adequate supplies of HIV test kits, ARVs, EDTA test tubes, and viral load consumables at all times.

Dr Kenneth Kaunda being honoured by President Lungu for his support to end HIV in Zambia

… and First Repoublican President, Dr Kenneth Kaunda was honoured by President Lungu for his efforts in fighting HIV in Zambia. President Kaunda will be one of the Ambassadors for the campaign. Others include Innocent Kalaluka a.k.a Smooth IK; award winning musician, B’Flow; and Keembe Member of Parliament, Hon. Princess Kasune Zulu.