CIDRZ Awarded Stop TB Partnership TB REACH Grant

        

The implementation science project, Achieving TB Control in Zambia through Scale-up of Innovative Diagnostic Tools and Proven Active TB Case-Finding Interventions, will conduct systematic health facility and community-based case-finding interventions complemented by highly-sensitive screening and diagnostic tools to initiate a sustained increase in TB case detection in high-burden settings. The project will be implemented in collaboration with the Zambian Ministry of Health and the National Tuberculosis Programme.

Zambia is among the thirty highest TB burden countries globally but has low TB case detection of 58%. Promising diagnostic tools such as Xpert MTB/Rif have shown a limited impact on TB treatment outcomes when placed in health facilities because health system and patient-level barriers to accessing screening services are not addressed. To reach the desired TB detection and treatment impact, placement of highly-sensitive tools must be accompanied with interventions that allow maximal patient access to screening, diagnostic, and treatment services closer to home. This project will target ‘high-risk for TB’ Lusaka peri-urban dwellers in George compound through community awareness raising activities in combination with community and facility-level active TB case-finding and proven screening procedures.

The project is expected to:

  • increase community awareness resulting in increased demand for TB screening
  • increase knowledge about TB/HIV among healthcare workers
  • increase TB screening in all health facility departments with use of exit screening and cough monitors
  • reduce time to TB diagnosis
  • strengthen contact tracing through use of a combination of screening algorithms to ensure that only high-risk patients get a definitive TB diagnostic test. Use of highly sensitive screening and diagnostic tools at the community level will allow maximal access to TB diagnosis.

The Achieving TB Control in Zambia through Scale-Up of Innovative Diagnostic Tools and Proven Active TB Case-Finding Interventions project is supported by the Stop TB Partnership’s TB REACH initiative and is funded by the Government of Canada and the Bill & Melinda Gates Foundation. The Principal Investigator is Dr Monde Muyoyeta MBChB, PhD, Director of CIDRZ TB Programmes.

CIDRZ 2017-18 HealthCorps Fellows

2017 – 2018 CIDRZ HealthCorps Fellows

Belinda Chihota, MSc-Control of Infectious Diseases (London School of Hygiene & Tropical Medicine, UK)

Belinda is from Zimbabwe and has worked with Doctors of the World U.K., the Medical Research Council Uganda Virus Research Institute, and the Zimbabwean Biomedical Research and Training Institute. She will be attached to the International Epidemiological Databases to Evaluate AIDS (IeDEA) study group working on HIV/Hepatitis B co-infection research.

Dr Neha Buddhdev, MD, MSc-Immunology and Global Health (University of Ireland)

Neha is from Kenya and has worked at the U.S. Army Medical Research Directorate-Kenya studying Flavivirus epidemiology. She will be attached to the CIDRZ Enteric Disease and Vaccines Research group and will contribute to our epidemiological studies assessing the burden of enteric pathogens in Lusaka to assist in the design of future vaccines and therapeutics clinical trials.

Marrit Habets, MSc-Microbiology/Immunology (University of Groningen, Netherlands)

Marrit is from the Netherlands and has conducted research on immune recognition and clearance of the Streptococcus pneumoniae pathogen, worked as a laboratory consultant on work-flow monitoring at Makerere University-Walter Reed Project in Kampala, Uganda and the University of the West Indies in Kingston, Jamaica, where she took part in setting up Zika virus diagnostics. She will be attached to the CIDRZ Laboratory.

Michelle Eglovitch, MPH-Maternal and Child Health (Boston University, USA)

Michelle is from the USA and has worked as a Research Assistant for the Pregnancy Health Interview Study at Boston University School of Public Health, and as a Program Analyst for Women’s and Infant Health at the Association of Maternal and Child Health Programs. She will be attached to the PMTCT Programme.

Jill Kadota, MPH-Epidemiology and Biostatistics (University of California, Berkeley USA)

Jill is from the USA and has performed data analysis for a randomized trial amongst people living with HIV in Shinyanga, Tanzania. She will be attached to the Analysis Unit.


University of Alabama at Birmingham Sparkman Center for Global Health  – supported CIDRZ HealthCorps Fellows 

Mbaita Shawa, MPH – Global Health (Simon Fraser University, Canada)

Mbaita is from Zambia and has previously worked at the Zambia Center for Applied Health Research and Development (ZCAHRD) on an Early Childhood Development project. She will be attached to our Qualitative Research team.

Dr Chileshe Mabula, MBChB (University of Zambia)

Chileshe is from Zambia and also holds a BA in Human Development from the University of California, San Diego. She has implemented a successful intervention for adolescents living with HIV in Eastern Province, Zambia, and has worked as a Medical Officer in Chipata where she developed a keen interest in improving patient engagement and access to care.  She will be attached to the Clinical Trials Team.

Learn more about our partner The UAB Sparkman Center for Global Health here

CIDRZ is also a host site for Global HealthCorps Fellows

Belia L. Ng’andwe, BA-Development Studies (University of Zambia)

Belia is from Zambia and has worked as Assistant Program Coordinator for Restless Development Zambia responsible for managing/ mentoring interns and volunteer peer educators who implemented project activities on the ground. Belia was behind Restless Development’s ‘Girls Like Us’ project focusing on reducing girls’ vulnerability and sexual reproductive health risks by empowering them with skills to contribute to household income. She will be attached to the Paediatric HIV Department.

Meave Otieno, MSc – Public Health Microbiology (George Washington University Milken Institute of Public Health, USA)

Meave is from Kenya and the USA.  She was a Peace Corps volunteer working as a Health Extension Agent in Togo; has done a practicum with the Elizabeth Glaser Pediatric AIDS Foundation working on research study protocol development; and assisted with data management in a palliative care study of people living with HIV/AIDS while a research trainee at the Children’s National Medical Center. She will be attached to the CIDRZ TB Department.

Fogarty International Center and Office of AIDS Research, NIH Global Health Equity Scholars Consortium, Yale University Research Fellow

Shilpa Iyer, MSc (Pune University, India), PhD (University of Pennsylvania, USA)

Dr Shilpa has conducted post-doctoral research at the prestigious Dr Beatrice Hahn Research Laboratory at the University of Pennsylvania. While at CIDRZ she will conduct an acute HIV-1 infection point-of-care testing study. She will be supervised by Professor Dr Sten Vermund, Dean of the Yale University School of Public Health and Dr Izukanji Sikazwe.

CIDRZ Launches New Implementation Science Directorate

CIDRZ is pleased to announce the launch of a new Directorate of Implementation Science. The U.S. National Institutes of Health defines implementation science (also referred to as implementation research) as “the study of methods to promote the integration of research findings and evidence into healthcare policy and practice. …It seeks to understand the behaviour of healthcare professionals and other stakeholders as a key variable in the sustainable uptake, adoption, and implementation of evidence-based interventions, …and has the intent to investigate and address major bottlenecks that impede effective implementation, test new approaches to improve health programming, and determine a causal relationship between the intervention and its impact”.

Dr Michael Herce, MD, MPH, MSc (Clinical Research & Epidemiology) will lead this new Directorate. Dr Herce is a US-trained infectious disease specialist, with close to 10 years of experience in HIV and global health programming and clinical and implementation science. Dr Herce worked in Malawi with Partners in Health from 2009 to 2012 and has worked in Zambia with CIDRZ since 2014. 

In Malawi, Dr Herce worked with the Ministry of Health to scale-up Option B+ in Lilongwe and surrounding districts and was instrumental in helping develop the National Tuberculosis Program’s national roll-out strategy for the Xpert MTB/Rif TB diagnostic tool. Embedding implementation science into these and other programs, he and his colleagues demonstrated that excellent clinical and public health outcomes could be achieved for HIV and other diseases even in the most challenging settings by leveraging existing HIV service delivery platforms, investing in health systems strengthening and using data to drive programmatic innovation.

While at CIDRZ, Dr Herce has worked closely with TB Director Dr Monde Muyoyeta and TB Senior Technical Advisor Dr Stewart Reid to grow implementation science HIV/TB activities in the Zambian Corrections Service system while serving as the Principal Investigator of the Continuum study, and Investigator of Record for the TasP study. He also leads the EmpiriX implementation science study examining the effects of the Xpert TB diagnostic tool on health outcomes for HIV-positive presumptive TB patients compared to standard-of-care TB diagnosis.

The new directorate will work closely with other technical directorates to coordinate the CIDRZ-wide implementation science agenda, build our implementation research capacity, and help CIDRZ to fulfil our mission of improving access to quality healthcare in Zambia through capacity development, exceptional implementation research, and impactful, sustainable public health programmes.

Photo from left: CEO Dr Izukanji Sikazwe, Director of Implementation Science Dr Michael Herce, and Chief Scientific Officer Dr Roma Chilengi

 

CIDRZ at National Labour Day 2017

 

Every year Zambia celebrates Labour Day with a march past His Excellency the President and an opportunity to decorate a float to display an organisation activities and contribution to the nation. 2017 was no exception and this year CIDRZ took part in style! Over thirty staff members volunteered to march, and our float displayed our healthcare programme and training activities to improve health in Zambia through providing Voluntary Medical Male Circumcision, Cervical Cancer Screening, Preterm Resources, Education and Effective Management of Infants (PREEMI), TB programming to strengthen health systems in Zambia Correctional Services, and HIV Care and Treatment to help Zambia reach the UNAIDS 90:90:90 treatment targets.  Think CIDRZ for a healthy Zambia!

CIDRZ facilitates National ARV Logistic Systems Training

CIDRZ, with the support from the US Presidents Emergency Plan for AIDS Relief (PEPFAR) and the Centers for Disease Control and Prevention (CDC) partnership, is conducting a National ARV Logistics System Workshop to prepare health centre, hospital, District Health Management Teams, and Provincial staff to use the Standard Operating Procedures Manual for the Management of the National ARV Logistics System, and the job aids, to perform tasks necessary to successfully manage the Antiretroviral (ART) drugs logistics system.
During the official opening of the workshop, Chongwe District Health Director, Dr. Charles Msiska, emphasised the need for health workers to “give patients comprehensive care, don’t just see them as an HIV patient or look at numbers.”
The trainers guide being used was prepared as part of the U.S. funded DELIVER Technical Assistance support to the Ministry of Health and aims at strengthening logistics management of ARV drugs. DELIVER, is a six-year worldwide technical assistance support contract funded by the U.S. Agency for International Development (USAID) and PEPFAR.

Training Health Staff to Implement Differentiated Ways to Provide ART

With support from the U.S. Presidents Emergency Plan for AIDS Relief and CDC partnership, CIDRZ is conducting a Training of Trainers workshop on how to implement a differentiated care model for people on Antiretroviral Treatment (ART).

The training is aimed at preparing the community outreach teams to roll out the implementation of the Community Adherence Groups (CAGs) and the Urban Adherence Groups (UAGs) following the approval by the Ministry of Health to roll out differentiated care models.

With this model, clinically stable patients who have been on ART for a minimum of six months, can form a group of six members. The members of these groups in turn select one person per month to go and collect ARV’s on their behalf. This means that each member of the group is expected to visit the clinic twice a year – to collect drugs for their colleagues – but also to fulfil their clinical appointments as well.

This model will help reduce congestion in clinics, and give time for other members of the group to engage in other activities. With this model, we expect more retention of stable clients on ART as well as reduction in the workload for the existing health workers in healthy facilities.

This type of differentiated care programming will help Zambia to achieve the UNAIDS 90:90:90 treatment targets.

CIDRZ – SHARE LSHTM Support UNZA Civil Engineering WASH Research

CIDRZ through the LSHTM – SHARE Consortium recently awarded research grants to Changwe Mafuta and Simapimbi Munaye, both 5th year University of Zambia (UNZA) School of Engineering Scholars to finish their research on sanitation engineering projects that will benefit Zambia.

CIDRZ and the Sanitation and Hygiene Applied Research for Equity (SHARE) Consortium of the London School of Hygiene and Tropical Medicine (LSHTM) collaborated on the Creating Demand for Sanitation (SanDem) project with funding from the UK Department for International Development. It is through this project that CIDRZ was pleased to award 2000 British Pounds Sterling each to deserving UNZA Civil Engineering students Mr Changwe Mafuta and Mr Samapimbi Munaye. The research projects of these two gentlemen rose about the others in their specific aim to address local sanitation challenges from an engineering perspective. These grants will support the completion of these student’s research project work. Funding was made available by the UK Department for International Development (DFID).
Mr Mafuta’s project is titled “Developing a lever, eco-sanitary toilet that does not use water to fush faecal matter, and use solar energy to treat waste, while Mr Munaye’s project is “Improving sanitation through recycling of plastic solid waste materials.”

Attending the event on behalf of CIDRZ – which was part of the University of Zambia 2016 Academic Year prize giving ceremony – was Chief Scientific Officer Dr Roma Chilengi, Director of Human Resources, Roselyne Raelly and Coordinator of the CIDRZ SanDem project, Joyce Chinyama Chilekwa. The Vice Chancellor of UNZA, Dr Luke Evuta Mumba, officiated the event and wanted to recognize and appreciate all stakeholders in the engineering training. “This country cannot develop without a sound engineering desk,” he emphasized.

Meharry Medical College and Morehouse School of Medicine: Focusing on Adolescent Health and Empowerment

With support from PEPFAR and the U.S. Centers for Disease Control and Prevention (CDC) partnership, we were honoured to host a site visit to the Chainda South Clinic and Kamwala Health Centre Youth Friendly Rooms (YFR) with Dr James Hildreth, President of the Meharry Medical College and Dr Valerie Montgomery Rice, President of the Morehouse School of Medicine, both in the USA.

The purpose of the visit was to explore how these American Historically Black Colleges and University medical schools can become involved in PEPFAR and CDC-supported programmes in Zambia to specifically address the HIV epidemic amongst adolescents as these are high-risk populations for acquiring HIV and STD infections.

Drs Hildreth and Montgomery Rice are both educationalists and researchers and were very interested to learn more about the CIDRZ youth outreach programmes and how they offer HIV counseling and testing as well as sexual and reproductive health information to adolescents as well as encourage healthy social activities and academic engagement.

Vincent and Maxwell Mumba, trained Peer Educators explained what takes place at the Kamwala YFR, as well as during outreach programmes in communities and churches. “We can test as many as 200 youth during one outreach programme,” they explained.
Dr Montgomery Rice who is also Dean of the Morehouse School of Medicine remarked, “This adolescent programme is clearly impressive. Dr Hildreth and I will see how we can work with the programme to support their activities through an increased use of technology. We will also provide resources and support for career progression for the youth volunteers that are working under this programme.”

During their time in Lusaka the guests also had meetings with the Minister of Health, the Minister of Higher Education, Deans of the Health Sciences divisions at University of Zambia, and PEPFAR and CDC Representatives.

Providing Health Services and Sensitisation at Zambian Traditional Ceremonies

In the photo CIDRZ Senior Community Advisor Mr Fresher Maphiri and MC Community Coordinator Bright Jere meet with his Royal Highness Senior Chief Nacilele of Kaoma at his Royal Palace. Chief Nacilele is an advocate for medical male circumcision and encourages all men in his chiefdom to have the procedure. He says that all seven of his grand sons have been circumcised.

Zambia is blessed with over 70 distinct tribes and many have annual traditional ceremonies that bring throngs of tribesmen together to celebrate their cultural diversity. Events such as these provide an excellent opportunity to reach people with health services, accurate health messages, and dispel misconceptions.

With the support of the US PEPFAR and CDC partnership, CIDRZ community teams attend these events, and recently they traversed the country to provide HIV testing and counselling, and provide information and health messages about medical male circumcision, ART adherence and tuberculosis screening at the Nc’wala Traditional Ceremony of the Ngoni people of Eastern Province, followed by the Kuomboka Traditional Ceremony of the Lozi speaking people of Western Province.  Over 2000 people received HIV testing and counselling at these two events, and interested men were booked for medical circumcision at the nearest health facilities offering the service.

After the Kuomboka Traditional Ceremony, the CIDRZ team also were privileged to meet with six of the local Lozi traditional leaders, or their representatives, to seek the intervention of the Royal Highnesses to assist in increasing the uptake of health services, particularly of HIV testing, male circumcision (MC) and antiretroviral therapy (ART) adherence, amongst their people.

In addition to meeting with the KUTA, full cabinet of the Lozi Paramount Chief, the Litunga; they visited the Chiefs in Senanga, Kalabo, Mongu, Limulunga and Kaoma.

Construction of Nachitete Mini Hospital Gives Hope to Chongwe Community

 

Over the years, I have donated land for the construction of various government institutions including the Chongwe District Hospital and schools. All these have been done after seeing the need and demand for the critical services in my chiefdom,” expressed Her Royal Highness Senior Chieftainess Nkomeshya Mukamambo II.

The Nachiteti Mini Hospital

Our healthcare system must be effective, efficient, accessible, acceptable, equitable and safe to deliver quality service that improves patient outcomes.” Minister of Health, Hon. Dr. Chitalu Chilufya as he officially commissioned the health facility.

The facility was upgraded by the Zambian government. Speaking during the  event, Lusaka Provincial Minister, Hon. Japhen Mwakalombe said “the most vulnerable people who are in most cases – women and children – especially in rural areas, need well-designed healthcare and education systems closer to their households. This will not only make their lives better, but it will also encourage them to seek early medical care whenever they need it.

With support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the CDC partnership, CIDRZ is proud to have been part of the official opening of the Nachitete Mini Hospital in Chongwe District where we were on-site to provide HIV testing and counselling, and screening for cervical cancer.

In addition, CIDRZ will continue to provide HIV testing and counselling, Voluntary Medical Male Circumcision, and support the Option B Plus programme for HIV-positive pregnant or breastfeeding women offering them life-long antiretroviral treatment (ART). At the event we reiterated our commitment to work with the health facility to provide quality health services to the Nachitete area, including parts of Lusaka and Chilanga Districts which previously used to access services from other distant facilities. CIDRZ will continue to support and and strengthen the health system to ensure that the clinic becomes one of the ART centres in the District.