Centre for Infectious Disease Research in Zambia
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Hepatitis B and C Prevention, Screening, and Diagnostic Services at HIV Treatment Sites: International Epidemiology Databases to Evaluate AIDS.
(2026-Sep-01) Kuniholm MH; Murenzi G; Samala N; Yunihastuti E; Wandeler G; Kim HN; Plaisy MK; Perazzo H; Twizere C; Odhiambo F; Bopage R; Muula G; Lo Re V; Minga A; López-Iñiguez A; Nsonde DM; Kasozi C; Wati DK; Fox MP; Kirk GD; Messou E; Cesar C; Ebasone PV; Byakwaga H; Ross J; Chimbetete C; Yendewa GA; Jaquet A; Succi RCM; Maruri F; Brazier E
BACKGROUND: Prevention, screening, and diagnostic services for hepatitis B virus (HBV) and hepatitis C virus (HCV) can prevent morbidity and mortality in people receiving HIV care. However, there is limited information about the availability of HBV and HCV services at HIV clinics globally.
METHODS: The International epidemiology Databases to Evaluate AIDS (IeDEA) conducted surveys of service delivery and practices at participating HIV treatment centers from 7 regions. We used 2023 survey data to measure availability of HBV vaccination, HBV and HCV screening, HBV surface antigen (HBsAg), HBV DNA, HCV antibody, and HCV RNA testing. Multivariable logistic regression models were used to test associations of site characteristics with HBV and HCV services.
RESULTS: HBV vaccination was available on-site at 67.7% of 204 HIV treatment sites. Screening for HBV and HCV at HIV care enrollment was reported by 72.1% and 50% of sites, respectively. HBsAg, HBV DNA, HCV antibody, and HCV RNA testing were available on-site at 77%, 47.6%, 61.8%, and 44.6% of sites, respectively. Sites serving predominately rural (vs. urban) populations were less likely to report on-site availability of HBV DNA [odds ratio (OR):0.07; 95% confidence interval: 0.01 to 0.68; P = 0.02], HCV antibody (OR = 0.18; 95% CI: 0.04 to 0.92; P = 0.04), and HCV RNA (OR = 0.10; 95% CI: 0.01 to 0.90; P = 0.04) testing.
CONCLUSION: Life-saving services such as HBV vaccination, HBsAg, and HCV antibody testing were available on-site at most HIV treatment sites participating in the IeDEA network. Lower availability at rural sites suggests that expansion of services is important to eliminate HBV and HCV as public health problems in people receiving HIV care.
Validation of a Point-Of-Care Ultrasound for Hepatitis Among Front-Line Healthcare Workers Managing Chronic Hepatitis B Virus Infection in Zambia.
(2026-Sep) Bertoni C; Kanunga A; Sinkala E; Syabbalo E; Chitundu H; Chikwezi A; Chibundi C; Muula GK; Bosomprah S; Capra N; Lolatto R; Morsica G; Castagna A; Wallrauch C; Heller T; Vinikoor MJ
To close gaps in implementing care of people with hepatitis B virus (HBV) infection in resource-limited settings, we evaluated the accuracy of a novel liver point-of-care ultrasound (POCUS) protocol for hepatitis (PUSH) among front-line non-radiology healthcare workers in Zambia. At University Teaching Hospital in Lusaka, Zambia, from March to June 2024, we trained four nurses and six physicians with experience in HBV management, but not in ultrasound (US), in the PUSH protocol, which includes visualizing the liver in three windows (epigastric, subcostal and right transcostal) to identify cirrhosis-suggestive features and liver lesions suspicious for hepatocellular carcinoma (HCC). Then, consecutive adult participants with chronic hepatitis B (PWHB) alone or HBV/HIV coinfection underwent PUSH with operators blinded to clinical data. We evaluated the accuracy of PUSH for significant fibrosis and cirrhosis using transient elastography (TE) as the reference standard test (RST) and for liver lesions that were possible HCC using a comprehensive abdominal ultrasound by an experienced radiographer as the RST. Nonparametric analysis of the receiver operating curve (ROC) for PUSH was adjusted for operator type (doctor vs. nurse), sex and HIV status. Among 197 PWHBs analysed, 69.5% were taking HBV antivirals and 27.9% had HBV/HIV. According to RSTs, 17.7% of PWHBs had significant fibrosis, 11.6% had cirrhosis and 3.5% had liver lesions. PUSH had low accuracy for significant fibrosis, with sensitivity of 8.3% (17.5-41.4), specificity of 100.0% (96.1-100) and an area under the curve (AUROC) of 0.54 (0.43-0.65), moderate accuracy for cirrhosis, with sensitivity of 60.9% (38.5-80.3), specificity of 97.7% (94.2-99.4) and AUROC of 0.79 (0.69-0.89), and higher accuracy for liver lesions, with 85.7% (42.1-99.6) sensitivity, 98.4% (95.5-99.7) specificity, AUROC of 0.92 (0.78-1.00). After an expedited training, front-line nurses and physicians treating HBV in Zambia were able to use PUSH to diagnose cirrhosis with moderate accuracy and liver lesions with high accuracy, although confidence intervals around performance estimates were wide. Liver POCUS including PUSH may be useful in HBV management when laboratory systems and TE are lacking.
Corrigendum to “Management of Finegoldia magna–Associated Non-Puerperal Breast Abscess in an Adolescent Integration of Surgical Source Control and Targeted Antimicrobial Therapy” [Diagnostic Microbiology & Infectious Disease 116 (2026) 117422]
(2026-9) Sha Lala; Hua Fei; Tu Wanqing; Xie Xiaohong; Xu Leilai
Barriers to care: female university students' distrust and fear of accessing sexual and reproductive health services in Zambia.
(2026-Aug-17) Sehrt M; Nayame L; Mweemba O; Thorne J; Mumbula I; Menon JA; Mulawa MJ; Hamoonga TE; Abuogi LL; Hampanda K
BACKGROUND: Sexual and reproductive health (SRH) services are widely available in Lusaka, Zambia but use among adolescent girls and young women remains low. This study investigated the perceptions and experiences of a sub-sample of female university students accessing clinic-based SRH services.
METHODS: Thirty-four female students participated in focus group discussions in June-August 2022. Participants were recruited from a survey at a public university, where interested participants could opt-in to join focus groups discussing experiences and perceptions of SRH services. Focus groups were audio recorded, transcribed, and analysed using a line-by-line constant comparison approach in which a codebook based on the research questions was created a priori and revised as new codes inductively emerged. Key themes and illustrative quotes related to experiences and perceptions of SRH health care were identified.
RESULTS: The most salient theme was widespread fear of seeking SRH services and interacting with healthcare providers. Three sub-themes included: (1) receiving moral judgement instead of health information; (2) negative clinic experiences; and (3) privacy concerns. As a result, a second theme revealed a reliance on less effective contraceptive methods, describing that these culminating experiences have led to decreased interest for SRH services.
CONCLUSION: As one of the few qualitative studies on female university students in a high HIV-prevalence setting, we identified key barriers in the healthcare system that hindered the use of critical SRH services. This research contextualised the use of less effective contraceptive methods, low uptake of pre-exposure prophylaxis, and persistent suboptimal SRH outcomes in this sub-population of young women.
Antimicrobial Resistance Microbiological Dataset (ARMD-UTSW): Electronic Health Record Based Data for Research
(2026-8-6) Cooper Lauren N.; Beauchamp Alaina M.; Ingle Tanvi A.; Diaz Marlon I.; Hanna John J.; Nateghi Haredasht Fateme; Amrollahi Fatemeh; Kanjilal Sanjat; Chen Jonathan H.; Perl Trish M.; Lehmann Christoph U.; Medford Richard J.