160 Volunteers trained in Index Testing

When the UNAIDS declared the 90-90-90 targets: 90% of people knowing their HIV status, 90% of people with HIV initiated on treatment, and 90% of people achieving viral suppression by 2020, national governments and organisations have come with different strategies towards achieving these targets.

With support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR), U.S. Centers for Disease Control and Prevention (CDC) and the University of Maryland partnership, CIDRZ is implementing index testing and partner notification, a strategy aimed at closing the gap to achieving the first 90%.

As a key partner for the Zambian Ministry of Health, CIDRZ has been supplementing government’s efforts towards attaining these goals through capacity building and health system strengthening activities.

CIDRZ trained 160 volunteers from various health facilities in Lusaka, in communications skills needed to conduct index testing.

During the training, CDC Public Health Specialist, Kennedy Nkwemu said “Index Testing focuses on improving the wellbeing of people living with HIV (PLHIV). The strategy is one of the priorities for PEPFAR in order for Zambia to achieve the 90-90-90 goals. Zambia is doing well with the second 90, but there is need to improve on the first 90, and this is where index testing comes in.”

Mary Mwapa, a Volunteer from Matero clinic said, “The skills and information I have acquired from this training vital and useful to my work. I am Grateful to CIDRZ and its partners for this opportunity.”

Index testing is a voluntary process where counsellors or health care workers ask a newly diagnosed HIV positive individual or an HIV positive individual already accessing HIV treatment to list all of their sexual or injecting drug partners, and children. With consent from the individual who is HIV positive, each listed partner and child is contacted, informed that they have been exposed to HIV, and offered voluntary HIV testing services. Index testing is consensual, confidential, and includes counselling, correct test results and connection to treatment or prevention services.

PEPFAR/CDC awards CIDRZ USD25m “Lab Innovation for Excellence (LIFE)” Grant

We are proud to announce that following a highly competitive process, CIDRZ emerged successful and was recently awarded a new co-operative agreement to implement the “Scaling Up Lab Services for Viral Load and Early Infant Diagnosis Testing to Meet the 90/90/90 Goals” project otherwise known as Lab Innovation for Excellence (LIFE).

It is a great honor for our organization that the United States Government, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and Centers for Disease Control and Prevention (CDC), has once again called on CIDRZ. Our selection demonstrates the central importance of CIDRZ within the health landscape in Zambia, and that we are considered a trusted and capable partner by all stakeholders.

LIFE is a USD 25 million five-year project that aims at improving lab hubs in four provinces – Eastern, Lusaka, Southern and Western Provinces. This grant will enable CIDRZ to further strengthen our model partnership with the Ministry of Health through which we work to build a strong and sustainable health system for the delivery of quality healthcare to Zambians and control of the HIV epidemic.

This project will work in the third 90: monitoring of clients on anti-retroviral therapy and this will be scaled up to ensure clients’ needs are met.

LIFE will work towards strengthening the health systems by:

  • improving sample courier networks
  • providing equipment and personnel
  • improving quality management systems and
  • providing stable power (green energy among them) at pre-analytical level
  • improving data flow from facility, to testing

We have received this grant due to the excellence of the CIDRZ Central Laboratory team which has made us competitive. Dr Ranjit Warrier is the Principal Investigator for this project

 

Dr Izukanji Sikazwe

CEO and Director

CIDRZ Gets new Award: Mental Health Capacity Building Trial (CBT)

We are pleased to announce that CIDRZ has been given an award of a grant for a study “Evaluating Implementation Strategies to Scale-up Trans diagnostic Evidence-based Mental Health Care in Zambia”otherwise known as “Mental Health Capacity Building Trial (CBT).”

Mental Health CBT is an implementation science award from the National Institute of Mental Health at the United States National Institutes of Health (i.e., US government). This is a five year (2018 – 2023) project and whose Principal Investigator is Dr Izukanji Sikazwe with Dr Michael Vinikoor being the Co-Investigator.

During the life of the project, we will develop and test a technology-based training tool to increase capacity to provide mental health care in Zambia.

This is the first ever and largest project for CIDRZ in the field of mental health and will build on:

  1. CIDRZ knowledge of and experience working within the Zambian health system
  2. Track-record in training lay and professional health workers, and
  3. Capacity to conduct rigorous research.

The project team will focus on closing the gap in local Zambian expertise in cognitive behavioral therapy (CBT). CBT is a form of psychotherapy that treats problems and boosts happiness by modifying dysfunctional emotions, behaviours, and thoughts. It focuses on solutions, encouraging patients to challenge distorted cognitions, and change destructive patterns of behaviour.

Zambian counselors who already provide a type of CBT called CETA (Common Elements Treatment Approach) will be trained to become expert trainers of CETA.

Mental health (which includes a broad array of conditions like trauma, anxiety, depression, and alcohol and drug abuse) is neglected in Zambia and expanding local capacity for treatment is a priority to improve the health and well-being of the Zambian people. Historically there have been inadequate local experts to train local counselors in evidence-based CBT techniques like CETA. If the pool of local expert trainers Is expanded, those experts can then train and supervise local counselors, which could help scale-up the capacity to tackle these problems within the health system.

 

Saving Mothers Giving Life initiative helps reduce Zambia’s maternal mortality

SMGL results where shared with stakeholders in Lusaka, Chipata, Mansa and Livingstone

According to the 2007 Zambia Demographic and Health Survey (ZDHS), Zambia’s maternal mortality ratio was 591 per 100,000 live births.  These statistics make Zambia one of the highest countries in Sub Sahara Africa with the highest morbidity and mortality rates.

In 2010, Zambia developed a Maternal, Newborn and Child Health (MNCH) roadmap for reducing maternal, neonatal and child mortality.

With support from U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. Centers for Disease Control and Prevention (CDC), the United States Agency for International Development (USAID), Department of Defense (DoD) and Peace Corps as well as global and multiple implementing partners, a “Saving Mothers, Giving Life” (SMGL) initiative for accelerated reduction of maternal, newborn and child mortality was launched.

SMGL results launches involved different stakeholders including the traditional leadership

This public-private partnership initiative was implemented in 18 of Zambia’s districts with the aim of addressing  three major challenges contributing to maternal and new born deaths. These are delays; in decision to seek appropriate care, reaching care timely and receiving quality, respectful care at the health facility.

CIDRZ was among non-governmental organisations to implement the SMGL initiative from 2012 to 2016. In order to share the outcomes of the programme, CIDRZ with PEPFAR and CDC support hosted SMGL dissemination meetings in Lusaka, Eastern, Luapula and Southern provinces for various stakeholders.

CDC Deputy Associate Director for Programs, Dr. Mary Boyd said during the Eastern Province SMGL dissemination meeting that “when we launched the five year partnership in 2012, we set out ambitious goals of reducing maternal deaths by 50% and perinatal deaths by 30%. Although these goals were overly ambitious, we were right to set our sights high. Preliminary results showed a 45% reduction in maternal mortality from 2012 to 2016. This is a clear indication that a health systems strengthening approach can achieve remarkable results”.

SMGL launches attracted a lot of stakeholders

And U.S. Peace Corps SMGL Program Manager, Ms. Sally-Rose Mwachilenga told the meeting in Luapula Province that “we are proud of SMGL’s accomplishments to-date and optimistic about the partnership’s long term impact on communities and families. As we close out the SMGL initiative, we must acknowledge that saving the lives of mothers and babies can only be sustained when there is zero tolerance for preventable deaths.  we must strive to create systems that help us identify not just every maternal death but every perinatal and neonatal death because knowing why they died is the first step towards creating systems to curb these deaths.”

Health workers attitudes, key to HIV linkage to care

Tila Mainga presented on “Results from the Stigma Ancillary Study” during CIDRZ Research Meeting

Health Care Workers, like all other community members are affected by HIV stigma. But Health Workers have a special role in providing services to clients and so addressing stigma is especially important.

These were some of the conclusions made by Tila Mainga, Study Manager at ZAMBART, when she presented on “Results from the Stigma Ancillary Study” during the CIDRZ weekly research meeting.

The study’s objectives were to ascertain how stigma among health care workers impacted on linkage to care with specific focus on health care workers attitude towards key populations and clients living with HIV, their perceptions of  experiences of clients living with HIV in the health facility physical spaces and internalized stigma among health care workers living with HIV.

On  attitudes towards key populations, the study found that health Care Workers  talk badly to pregnant adolescent girl as they believe that  pregnant  adolescents are promiscuous and engage in high risk sexual behaviors.

The study also revealed that sex workers face a lot of stigma in the clinic and in the community and lose  interest in accessing health care services due to long queues and waiting times is perceived as a risk of  them being identified.

Tila explained  “however, there is a contrast in the nature of the relationship between People Living with HIV and Health Care Workers. On one hand some described it as friendly and supportive while on the other, it was described it as rude and unaccommodating”.

She pointed out that “some health facilities have no privacy ,as a result there is information leakage as to who is HIV positive and who is not. Some communication materials found in health facilities are too obvious that they are symbols of an HIV positive person, hence chances of being stigmatized are high”

The study concluded that there was still more that could be done to reduce stigma levels by health care workers especially towards populations at high risk of HIV.

 

President Edgar Lungu thumbs up CIDRZ

President Lungu listening to CIDRZ TB Clinical Care Specialist, Dr Mary Kagujje during the official launch of the National Health Week at OYDC

In line with our mandate to ensure equitable access to health services in Zambia, the Centre for Infectious Disease Research in Zambia (CIDRZ) is participating in this year’s National Health Week.

The Health Week, whose theme is “Healthy for All, Leaving No One Behind” was officially opened by the Republican President, Edgar Lungu on Tuesday at the Olympic Youth Development Centre (OYDC).

CIDRZ is providing services at the OYDC which include: HIV Testing, ART clinic, cervical cancer screening, TB screening using Gen Xpert Machine, adolescent HIV Testing and information dissemination, and recruitment of study participants for the HIV Vaccine Trials.

CIDRZ provided a range of services at OYDC during the National Health Week

All this is with support from the United States (U.S.) President’s Emergency Plan for AIDS Relief (PEPFAR), and it’s partnership with the U.S. Centers for Disease Control and Prevention (CDC); Stop TB Partnership | TB REACH; MAC AIDS Fund; and the U.S. National Institutes of Health.

During the launch, President Lungu commended CIDRZ for offering mobile TB screening services and urged the ministry to procure such digital X-Ray machines for outreach purposes.

People lining up at the CIDRZ X-Ray truck

“It’s impressive to see a mobile X-Ray truck and I am happy that you are going in the community to screen people for TB. It will be a good idea for the Ministry of Health to purchase such mobile X-Ray machines for all our communities,” President Lungu said.

CIDRZ TB Clinical Care Specialist, Dr Mary Kagujje was on hand to give insights to the President on the services offered by CIDRZ.

Emmanuel Appiah Qua-Enoo

Emmanuel Appiah Qua-Enoo, BComm (Hons), MComm (SA&Intl Taxation, CA(SA) Deputy Chief Executive Officer

Mr. Emmanuel Appiah Qua-Enoo is a Chartered Accountant and a registered member of the South African Institute of Chartered Accountants. He holds a Bachelor of Commerce (Hons) Degree from the University of Natal, and a Master’s Degree in International Taxation from the University of Johannesburg, and an alumnus of the United States Venture Capital Institute.

Mr. Qua-Enoo worked at PricewaterhouseCoopers in their Johannesburg Practice where he specialized in Financial Services and Management of Internationally Funded Institutions. He has consulted widely for numerous international donors and their recipients across Africa.  He has worked at USAID’s Office of the Regional Inspector General in Pretoria where he was responsible for the management of all Non-Federal Audits in Eastern and Southern Africa, covering 21 countries. He was also the Chief Financial Officer of the Southern Africa Enterprise Development Fund, a USAID sponsored Private Equity and Venture Capital Fund that invested in Southern Africa.

Michael Herce MD, MPH, MSc

Dr. Michael Herce is the Director of Implementation Science at CIDRZ, an Honorary Lecturer at the University of Zambia, and an Assistant Professor of Medicine in the Division of Infectious Diseases at the University of North Carolina (UNC), USA. As a US-trained infectious disease specialist, Dr. Herce’s work focuses on understanding and ameliorating health inequities in HIV and TB prevention, treatment, and care for key and vulnerable populations in sub-Saharan Africa through patient-oriented and implementation science research. His research and service delivery projects have been funded by the US NIH, UNICEF, USAID, PEPFAR/CDC, and DFID/UKAID. Before joining CIDRZ in 2014, he served as Clinical Director for Partners In Health—Malawi and Chief of Party for TB CARE II. Dr. Herce completed his residency in Global Health Equity and Internal Medicine at Brigham & Women’s Hospital/ Harvard Medical School and his Infectious Disease fellowship training at UNC. He received his MD cum laude from Yale, his MSc in Clinical Research from UNC, and his MPH in Global Health from Harvard.

David Ojok MSc, MPH

David has worked with CIDRZ Central Laboratory for the last four years as Head of Laboratory QA/QC and has been central in establishing, coordinating, and monitoring lab Quality Management Systems (QMS) programmes at the Central Laboratory. He has 15 years’ experience in the operations and QMS of clinical and research laboratories. Before moving to CIDRZ Central laboratory, he worked as Lab Shift Leader at Makerere University and Johns Hopkins University Core Lab (MU-JHU Core Lab) at Makerere University. He has vast experience implementing and monitoring of both College of American Pathologists (CAP) and ISO 15189 QMS. He is a vetted nominated representative for accreditation, ISO 15189 Lab Technical Assessor, and an advisory committee member on the Medical Laboratories Accreditation Programme for SADCAS. He has experience working with Division of AIDS National Institutes of Health (DAIDS/NIH) clinical trial Networks including HIV Vaccine Trials Network (HVTN), International Maternal Paediatric Adolescent AIDS Clinical Trials Network (IMPAACT), PROMISE, Microbicides Trial Network (MTN), and AIDS Clinical Trial Group (ACTG).
He is currently pursuing his PhD studies in International Public Health.

CIDRZ, partners hold first media science café on clinical trials

Media cafe participants actively following the discussions around ethical conduct of clinical trials and the role of the media in report on health in general, and clinical trials in particular

Despite education and treatment advances towards HIV e.g. provision of Anti-Retroviral Therapy (ARV’s), male circumcision, prevention of mother to child transmission of HIV, the rates have not dropped as much as they should have.

While ARV’s have been very helpful in fighting the epidemic, they are expensive and depend on continuous supply hence the need to find a long lasting cost effective method of addressing this challenge.

To address this, CIDRZ is part of the HIV Vaccine Clinical Trials (HVTN) that seek to develop a Safe and Effective Vaccine for Prevention of HIV Infections Globally.

Prevention of HIV transmission, is the long term global solution for the HIV pandemic. Current methods are working but Protection by these interventions is limited by

  • Need for long-term continuous adherence
  • Continuous uninterrupted access to products and
  • Sustainable donor and public funding.

“Ultimately, we believe, the only guarantee of a sustained end of the AIDS pandemic lies in a combination of non-vaccine prevention methods and the development of a safe and effective HIV vaccine.”

A vaccine able to prevent HIV infection would have a significant impact on the health, social and economic burden of HIV/AIDS and recent modelling studies showed that introducing a partially effective (30%) with limited coverage in Southern Africa could result in an significant reduction in HIV incidence compared to a non-vaccine scenario.

We took a media tour with journalists to the CIDRZ HVTN Site at Matero referral Hospital and CIDRZ Central Lab in order to showcase the state of the art equipment that CIDRZ uses for its services and clinical trial

CIDRZ, Zambia Emory HIV Research Project (ZEHRP) and Zambia Institute of Mass Communication Education Trust (ZAMCOM) held a media café to raise awareness among journalists and the community on HIV vaccines, ethical conduct and the role of the media in the process.

In addressing journalists, ZEHRP Director Dr William Kilembe explained that “the rationale behind the vaccine trials is to find an intervention that has significant effect on reducing new HIV infections.”

The media science café, was attended by more than 25 journalists from different media houses to acquaint them on their role in health reporting and HIV vaccine trials in particular with a specific focus on HIV prevention research updates, current HIV vaccine trials in the region and globally as well as clinical research concepts.

Former Times of Zambia News Editor, Enock Ngoma said “the media are a key stakeholder that has to be involved in the entire process of any clinical trial. People believe what they read in the media and therefore the media will play a critical role in making people understand the objectives, processes and procedures of clinical trials. This is a step in the right direction for journalists to develop interest and gather prior knowledge about the trials, design process, participants and duration. I must commend CIDRZ and partners for bringing journalists together in this manner”.

Another participant, Nicholas Bwalya of Metro FM added that “journalists need more of such platforms to interact with researchers and inculcate the interest of health reporting in them. This is the only way we can understand the jargon that always has always posed a challenge to report on health research and outcomes”.

CIDRZ Communications Manager, Daniel Banda, making a presentation on the role of the media in reporting on clinical trials

Meanwhile, CIDRZ Communications Manager Daniel Banda pointed out that “media is one of the most important stakeholders in every community. The media has influence on funders, policymakers, & even ethics review committees, hence the reason of our meeting here. Health affects everyone and almost no other news or specialist topic has such a universal audience in all media like health”.

And ZAMCOM Director, Oliver Kanene said “we are happy to partner with CIDRZ especially that the inaugural  media science café was at CIDRZ years ago. The goal for this platform is simply to bring science to a level where everyone understands. Science is worthless if it is not shared with people but sharing can only happen if the media first understand the processes involved”.