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 (

Differentiated Models of Care: Encouraging ART Patient Retention into Care


Nessia Tembo on her way to Matero Main Clinic to collect her medication

Community based ART delivery models have been shown to reduce the burden and strain on the local health system. These models have shown improved outcomes that include better patient retention in care, reduced clinic congestion, and patient satisfaction.

Nessia Tembo of Matero was one of the over 400 participants  who took part in the CIDRZ Fast Track Model, one of the four differentiated models of care implemented during the Community ART for Retention in Zambia study through funding from the Bill and Melinda Gates Foundation. The other three were Community Adherence Group(CAG), Urban Adherence Group (UAG) and Streamlined ART Initiation (START).

Nessia shared her experience, “I was working part time and usually getting leave from work to go the health facility would be a challenge and for fear of losing my job, I would default going for my clinical  appointment just to keep my job. The hours I would spend from having my file pulled to collecting my drugs were long. When the Fast Track model was introduced, I spent less time at the health facility during my ART visits giving me enough time to go back to work and even attend to other family engagements.”.

Nessia receiving her ARV’s from the Pharmacist at Materos Main Clinic

“It is sad that the study has come to an end. If only those of us that took part in the study could be trained and mentored, we would form groups to ensure continuity of the model”.

The Zambian Ministry of Health had authorised  implementing partners to pilot different models of community-based ART service delivery to determine best models of dealing with retention into care of HIV positive clients.

This was in response to the challenges that the health sector was facing. Under the Community ART Study (CommART), CIDRZ conducted a study whose objectives were:

  1. To determine the acceptability, appropriateness, and feasibility of a differentiated care system in Zambia.
  2. To evaluate the effectiveness, efficiency, and health care quality of a differentiated care system that includes targeted models of care.
  3. To develop a “methodologic” toolkit for assessment of local needs and preferences and for implementation during scale-up of differentiated care models in this and in other contexts.

Four models were piloted: one Community model and three facility models. These were the Community Adherence Groups (community model), and the Urban Adherence Groups, FastTrack and Streamlined ART Initiation (facility models).

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.

Better Drug Storage Conditions Equals Quality Medication for Patients

Aircon installed at Katoba RHC in Chongwe

Even though there were adequate drugs to supply the patients, facilities in Chongwe district faced challenges in ensuring appropriate storage conditions for drugs.

The Centre for Infectious Disease Research in Zambia (CIDRZ) is currently supporting 29 facilities in Chongwe District. All the facilities including the district pharmacy had no functional air conditioners in the pharmacy store rooms to maintain appropriate temperatures for storage of drugs at the time CIDRZ started supporting Chongwe District. The few facilities with room thermometers recorded temperatures of above 35˚C to 40˚C especially in the hotter seasons. This is above the recommended temperature range of 15˚C to 30˚C. This exposure of drugs to uncontrolled temperatures is a risk to reduced potency of drugs, hence lowering their efficacy. Some facilities opted to ordering and storing fewer drugs so as to reduce on the period of exposure to the unfavorable storage conditions.

“I just notice color change in some drugs and guess that heat has damaged the product,” said the nurse at Katoba Rural Health Center.

The solution to this challenge was not to reduce stored quantities, but to have an effective temperature control system – air conditioners accompanied by room thermometers and temperature charts for daily monitoring of room temperatures.

In November 2017, CIDRZ, through the Pharmaceutical Services Department began an air conditioner installation exercise in Chongwe District. The District was supported with 14 air conditioners paired with installation accessories. This activity was done in close collaboration with the Chongwe district medical office whose technician was the installer.  In February 2018, we also distributed room thermometers and temperature charts to 10 facilities in Chongwe district.

Facility staff are confident that the improved storage conditions will help maintain drug’s effectiveness during the shelf life. This came with mentorship on the use of the equipment, temperature monitoring and maintaining the pharmacy store room in order. They gave an assurance of taking care of the items given to them.

“Temperature will be maintained in appropriate range all year round! I will no longer feel guilty when dispensing drugs because they were kept within recommended temperature range as I am assured of safety and efficacy.” said pharmacy technologist Ngwerere Main Clinic.

“The community of Katoba will no longer complain of coming across discoloured brittle-tearing latex male condoms.” said a peer based at Katoba Rural Health Center.

“Facilities can now keep adequate quantity of stock without worrying on the products deteriorating during its storage period.” said the district pharmacist.

Based on the success of improving storage conditions, the district medical office also supported 2 facilities with air conditioners. The status for storage now stands at 58% of facilities installed with air conditioners, 73% have room thermometers all with temperature logs and 86% have the store room arranged in appropriate order.

CIDRZ has in its plan to continue improving storage conditions of drugs to ensure that quality drug product is dispensed to the patient for desired therapeutic outcomes. It is planned that by the end of 2020, 90% of CIDRZ supported facilities in Chongwe adhere to recommended storage guidelines. This is one of the organisations ways to improve access to quality healthcare in Zambia.

CIDRZ employees donate blood

Dr Mulenga, Medical Director

The importance of blood in one’s life could never be overemphasized. The billions of cells in our bodies need a steady supply of oxygen to function properly, a function critical to blood.

Zambia for example collects an average of 115,742 units of blood annually (based on 1% of national population) currently short the 150,000 units the country needs to service everyone in need of this life saving fluid.  With high and rapidly increasing demand for blood and blood products, the annual units of blood needed are estimated at 300,000 units.

To support the Zambia National Blood Transfusion Service (ZNBTS), CIDRZ in collaboration with ZNBTS conducted a blood drive for its employees to donate blood to the blood bank, with 21 employees donating blood.

CIDRZ CEO, Dr Izukanji Sikazwe commended ZNBTS; “we appreciate the efforts of ZNBTS in saving the lives of millions of Zambian in need of blood. CIDRZ has benefited from your services because barely two weeks ago, one of our staff members life was saved through blood transfusion and as an organisation, we thought it would be prudent to support ZNBTS’s efforts through the blood donation drive we are having today”.

And Dr Joseph Mulenga, Medical Director at ZNBTS highlighted some of the challenges being faced by the blood bank in meeting its annual targets.

“Countrywide Scale up of cancer treatment, cardiac surgery, renal treatment, increased hospital bed space through the upgrading of hospitals and newly built hospitals country wide, high prevalence of HIV and Hepatitis B Virus in the general population, lack of a cost recovery or re-imbursement scheme to fill the financing gap and reliance only on government for funding are some of the challenges faced by ZNBTS”.

Dr Mulenga said added to the challenges is lack of Nucleic Acid Amplification Testing (NAT) to complement serologic tests for testing of blood for Transfusion Transmissible Infections such as HIV, Hepatitis B Virus and Hepatitis C Virus  and capacity for Apheresis, Stem Cell collection and processing, Leucodepletion and Gamma Irradiation of products, HLA, Tissue Typing and Pathogen Inactivation procedures.

To mitigate these challenges ZNBTS has established Provincial Blood Transfusion Centre in all the 10 provinces to mobilize and recruit more voluntary non remunerated blood donors, conduct blood donor counseling, implement blood donor retention programmes & promote repeat blood donations.

Other measures include collecting 300,000 blood units (2% of estimated national population) per year, scale up blood component production, implement Apheresis procedures at 10 Centre’s, collect Platelets, FFP, plasma, 2-RBCs, source plasma, granulocytes, HLA typing, Irradiation, leucodepletion stem cell harvesting, implement ID-NAT testing procedures, promotion of rational use of blood & blood products and introduction of a partial cost recovery programme.

CAGs – offering emotional support, retention to ART clients in Magoye

CAG members in Ceembe village of Magoye, with CIDRZ staff during the Community visit

This week, we have been visiting communities in Magoye district, visiting Community Adherence Groups – CAGS. Interesting to visiting communities and see how they appreciate the efforts that CIDRZ is making in ensuring that people access ART with “ease” CIDRZ, with support front the Bill & Melinda Gates Foundation.

With support from CIDRZ, the CAGs have brought a difference in individuals lives as well as communities – both intended and unintended. People are now free to talk about their HIV status and offer each other support for the challenges they encounter. Some of them have even broken the barrier that previously existed and are freely talking about their status in their communities.

CAG members watering the vegetable gardens in Ceembe village

One of the communities we visited, we were happy to find that the CAG has even gone a step further to start a livelihood project – they have a vegetable garden and a considerable amount of hectares for groundnuts.

We visited three communities to hear their views about the CAG’s and challenges they used to face prior to the introduction of the CAG’s. In one of the communities we visited, about 45km from Mazabuka, people face different challenges that include movement from their homes to the nearest clinic, Magoye.

“We have to cross the dam when going to the clinic and this is usually a challenge in the rain season when the dam overflows. When this happens we can’t use our bicycles, we just have to walk to the clinic to get medication. This is particularly a challenge especially for women,” narrates Herbert Mwiinga, CAG supervisor for one of the CAGs Ceembe village.

Herbert Mwiinga demonstrating on how they cross the part of the dam that overflows during the rain season

At clinic level, “we used to go and get our drugs on a monthly basis, often with long queues spending more time at the facility, but from the time CAGs were introduced at Magoye Healthy Facility, we alternate on drug collection amongst ourselves. We each go there twice in a year. This is indeed a good initiative,” he adds.

The ART in Charge at Magoye clinic is full of praise for the model, “the CAGs have helped us in terms of retention of ART clients. We no longer have long queues and ART clients don’t have to come here on a monthly basis as the case was previously. We are proud of this and thanks to CIDRZ and the donors for this initiative,” says Leah Mwale.

CAGs are a community-based HIV treatment model promoted to improve long-term retention in care. It combines clinical visit spacing, group drug-pick up and distribution in the community, and peer social support to reduce the high opportunity costs of clinic visits and promote patient self-management. Although existing data suggest that retention is higher in CAGs compared to facility-based care, the overall public health impact of CAGs depends on the fraction of eligible patients who take up the model.


CIDRZ renovates Maz Hospital, Chongwe Urban Clinic Laboratories – for improved service delivery

Renovations works at Mazabuka Hospital in Southern province

Laboratories play a critical role in the continuum of care for HIV positive patients. Laboratory tests and results provide the vital information needed for health workers and patients to manage the HIV virus and keep it under control for the health of the patient and reducing chances of passing the virus to others.

However, with a population of about one million people living with HIV in Zambia, there has been an overwhelming need for Anti-Retroviral Therapy (ART) laboratory services to be provided in all health facilities providing  ART care.

Through  generous funding from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and partnership of U.S Centers for Disease Control and Prevention (CDC), CIDRZ has been providing capacity building supervisory  and technical assistance aimed at accelerating government laboratory service improvements in  Lusaka, Western, Southern and Eastern provinces.

We have been identifying hospitals and clinics that need laboratories. In these facilities, we have renovated their laboratories and will procure equipment that will enhance their service provision at facility level. CIDRZ envisions a situation where ART services are provided as closer to the people as possible.

Chongwe Urban Clinic Laboratory renovations have been concluded

We recently visited Mazabuka Hospital and Chongwe Urban Clinics to inspect progress on renovations on the laboratories. We are proud that Chongwe works have been finalized while Mazabuka renovations are on course to being finalized.

This is aimed at building local capacity to provide onsite ART laboratory services, reduction in result turnaround time, full integration of operations with the Ministry of Health structures such as national forecasting, quantification, procurement, equipment maintenance plan and distribution and  as a  sustainability guarantee  of ART laboratory services.

mSpray: Spatial Data to Improve Intervention Coverage

Annie Martin, a Akros Research Associate & Programme Manager

According to UNICEF “of all people who die from malaria in Zambia, 50 percent or more are children under 5 years of age; 50 percent of under-5 hospital admissions are due to malaria; Malaria accounts for 20 percent of maternal deaths”.

The complexity of malaria, a preventable and curable disease requires several interventions to ensure an environment free of malaria. For many years prevention measures have been implemented to save lives from this disease and notable among these measures has been the indoor residual spraying (IRS) of walls with insecticides.
In order to make IRS more effective in combating malaria, Akros, an organisation whose work is mainly open platform agnostic, with projects largely focused on improving national information systems, in health, WASH and education, with an emphasis on community level surveillance has developed the mSpray tool to improve IRS operations and available tools that could facilitate that vision.

One of te spray team members showing off the cellular enabled tablets with maps that they use in the field during IRS

Annie Martin, a Research Associate and Programme Manager at Akros said during the CIDRZ weekly research meeting that “our programmers have created a tool that integrates Google’s mapping technology with intelligent overlays, putting the data in the hands of everyone, helping to drive the virtuous data cycle forward. No longer do we need to send spray teams out to the far corners of the country with instructions, hoping the spraying is happening in the right places. Now we can send them with cellular-enabled tablets with maps showing them where they are and where the next house is they need to find and spray. And thanks to GPS location tagging, we can now see each house they visited and sprayed as they file their reports, right from the field. And all of the data comes back in real-time”.

She said mSpray was associated with a significant 15% reduction in confirmed case incidence due to better targeting and achieving overall higher household coverage compared to the programme without mSpray.

Participants following the research presentation on IRS by Akros

“While reported operational coverage estimates were higher for non-mSpray areas, the ratio of structures sprayed per population achieved was higher for mSpray areas, suggesting better actual coverage was achieved in these areas leading to greater impact. The use of the mSpray electronic Monitoring & Evaluation tool appears to improve the effectiveness of the IRS programme, likely through allowing for better targeting, better coverage, and less biased estimates of coverage”.

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