Following a successful pilot program delivering rotavirus vaccines as part of an integrated approach to diarrhoea prevention and control, in November 2013, Zambia rolled out GAVI-supported rotavirus vaccines nationwide. Read more
In the following write-up, Dr Roma Chilengi, CIDRZ’s Director of Health Systems and Primary Care highlights CIDRZ’s objectives in its sanitation programmes and the advantages of implementing the Community-Led Total Sanitation (CLTS) model.
CIDRZ has partnered with UNICEF to work with the Government of Zambia, to improve equitable access and coverage of hygiene and sanitation practices in the rural communities of Chongwe and Kafue districts. Through the implementation of Community-Led Total Sanitation (CLTS) and School-Led Total Sanitation (SLTS) programmes, CIDRZ will collaborate to ensure that:
- 150,633 people have improved access to sanitation and hygiene facilities and have their own household latrines
- 20,859 school children in 24 schools have improved access to sanitation and hygiene facilities through construction of 190 Ventilated Improved Pit Latrines with hand washing facilities
The ambitious goal of this programme is to objectively demonstrate that targeted villages attain “Open Defecation Free (ODF) status”, that is, each household must have a toilet (with a lid and super structure), as well as a hand washing facility.
Such apparently simple interventions can help avert diarrhoeal disease if appropriately implemented. The CLTS model comes with several key lessons:
- To be sustainable, communities themselves must build and own their own toilets
- The involvement of traditional leaders, especially village headmen and chiefs as opposed to civic leaders is key
- Use proven triggering process and ensure trained professionals verify and certify ODF status
- With appropriate strategies, ODF can be achieved in most rural places through cost efficient strategies
- CLTS champions need to be recognised and made proud as agents of change.
Appropriate toilets and hand washing with soap are key transmission breakers for most causes of diarrhoeal diseases and CIDRZ not only recognizes that; it is in the forefront to support primary prevention; PREVENTION IS BETTER THAN CURE!
CIDRZ researcher Professor Groesbeck Parham will lead the Zambian ‘EPIC’ biomarker study searching for a biomarker of persistent high-risk Human Papilloma Virus (HPV) infection as part of a grant to the African Collaborative Center for Microbiome and Genomics Research. The U.S. National Institutes of Health (NIH) recently announced the 4-year grant award of $4.16 million to support the work of the Institute of Human Virology in Nigeria, and CIDRZ, to better understand the epidemiology of HPV infection and cervical cancer. “Cancer of the cervix is the most common cancer in Africa. This grant will address a high-impact public health challenge that affects women’s health in Africa and the rest of the world,” NIH said.
The African Collaborative Center for Microbiome and Genomics Research (ACCME) is a multi-country, multi-institutional collaborative research group involving the Institutes of Human Virology Nigeria and CIDRZ in partnership with international organizations, including Institutes of Genome Sciences and Human Virology, Cambridge University, UK; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA; and the Center for Genomics and Global Health, National Human Genome Research Institute, Bethesda, Maryland, USA.
OBJECTIVE: Neonatal male circumcision (NMC) is not routinely practiced in Zambia, but it is a promising long-term HIV prevention strategy. We studied the feasibility and safety of three different NMC methods.
METHODS: We enrolled healthy newborns in a controlled trial of the Mogen, Gomco, and Plastibell devices. Doctors, nurses, and clinical officers were trained to perform Mogen, Gomco, and Plastibell techniques. Each provider performed at least 10 circumcisions using each device. Neonates were reviewed at 1 and 6 weeks after circumcision for adverse events.
RESULTS: Between October 2009 and March 2011, 17 providers (5 physicians, 9 nurse midwives, and 3 clinical officers) without previous NMC experience were trained, and 640 circumcisions were performed. The median infant birth weight was 3.2 kg (interquartile range: 2.9-3.5 kg), and median age at the time of procedure was 11 days (interquartile range: 7-18 days); 149 babies (23.3%) were exposed to HIV. The overall adverse event rate was 4.9% (n = 31/630), and the moderate-severe adverse event rate was 4.1% (n = 26/630). Rates did not significantly differ by method. Most providers (65%) preferred Mogen clamp over Gomco and Plastibell.
CONCLUSION: Doctors, nurses, and clinical officers can be trained to safely provide NMC in a programmatic setting. The 3 studied techniques had comparable safety profiles. Mogen clamp was the preferred device for most providers.
Authors: Bowa K, Li MS, Mugisa B, Waters E, Linyama DM, Chi BH, Stringer JS, Stringer EM.
Read the full-text article here
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