Centre for Infectious Disease Research in Zambia
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Recent Submissions
Corrigendum to "Drivers of decision-making for future adult vaccines: a best-worst scaling among community members and health care workers in Zambia" [Vaccine 70 (2026) 128003].
(2026-Jul-11) Le Tourneau N; Sharma A; Pry JM; Haambokoma M; Shamoya B; Sikombe K; Simbeza SS; Zulu N; Geng EH; Eshun-Wilson I; Kerkhoff AD
Unveiling the hidden burden: Common mental disorders among women attending antenatal care in selected health facilities of Lusaka, Zambia.
(2026) Jacobs C; Nkhowani J; Ngosa D; Shanaube K; Sandøy IF
Mental health disorders disproportionately affect women during pregnancy and postpartum, with high prevalence in low-income countries. Mental health disorders during the antenatal period can lead to serious complications for both mother and child, including preterm birth, developmental issues and postpartum depression. However, mental health screening remains neglected during the antenatal period in resource-limited settings. We investigated the prevalence and determinants of common mental disorders (CMD) among women attending antenatal care (ANC) in selected health facilities of Lusaka, Zambia. A cross-sectional study was conducted between 26th April and 6th July 2024 in two purposively selected health facilities in low socioeconomic areas of Lusaka. A systematic sample of pregnant women in the third-trimester attending ANC were invited to participate. Common mental disorders were defined using a cut-off score of ≥8 on the WHO Self-Reporting Questionnaire (SRQ)-20, administered through face-to-face interviews. Logistic regression models were employed to identify determinants of common mental disorders. Stata 18 SE was used for analysis. We included 331 participants who were predominantly young adults (50.5% aged 20-29), married/cohabiting (69%), and almost a quarter (23.9%) living with HIV. Most had unplanned pregnancies (58.6%), experienced pregnancy-related body changes (73.1%) and had delivery concerns (68.6%). The study found a high prevalence of common mental disorders (65.8%). Participants who were less than 20 years, primary level education, had history of complications during previous pregnancy, were worried about the birth process and reported unpleasant body changes due to pregnancy exhibited higher prevalence for common mental disorders. On the other hand, women with medium or high social connectedness had lower odds of common mental disorders. The high burden of common mental health disorders among pregnant women in Lusaka, Zambia, underscores the importance of integrating mental health screening and support into routine antenatal care, with targeted attention to high-risk groups such as adolescents.
Design and feasibility considerations for a phase 3 efficacy trial of the M72/AS01
(2026-Jul-11) Dagnew AF; Noble R; Cinar A; Burhan E; Churchyard G; Fairlie L; Hanekom WA; Muyoyeta M; Mwandumba HC; Nduba V; Curran M; Schmidt AC
BACKGROUND: M72/AS01
METHODS: We conducted event-driven simulations using lower bound (LB) of the two-sided 95% confidence interval (CI) for VE(D). For IGRA-positive participants, assumptions included 1:1 randomization, 9000 participants/arm, 0.4% TB incidence/year, 55% true VE(D), 5% dropout/year, and two-year enrollment. Enrollment irrespective of baseline IGRA status (mixed IGRA-status population) and IGRA-negative-only scenarios were explored to estimate sample sizes and trial duration.
RESULTS: Simulations demonstrated that 110 events rule out a VE(D) 95% CI LB ≤10%, and 185 events rule out ≤25%, assuming ≥90% power and a true VE(D) of 55%. With 18,000 IGRA-positive participants, simulations projected a 90% probability of accruing 110 events within 3.5 to 4 years and 185 within 5.5 to 6 years. In the mixed IGRA-status population, few endpoints occurred among IGRA-negative participants, yielding insufficient power. Standalone VE(D) evaluation in IGRA-negative participants required large sample sizes (approximately 134,800) and prolonged timelines, indicating infeasibility. Accordingly, the selected primary objective of the phase 3 trial was to confirm VE(D) in IGRA-positive HIV-negative participants using LB of 95% CI for VE(D) > 10% after 110 events; secondary objectives include safety and immunogenicity in HIV-negative IGRA-positive; HIV-negative IGRA-negative; and HIV-positive individuals irrespective of IGRA status.
CONCLUSIONS: An IGRA-positive-enriched, event-driven phase 3 trial is feasible to confirm VE(D) of M72/AS01
Corrigendum to "Intention to receive new vaccines post-COVID-19 pandemic among adults and health workers in Lusaka, Zambia" ["Vaccine 50 (2025) 126846].
(2026-Jun-20) Sharma A; Kerkhoff AD; Haambokoma M; Shamoya B; Sikombe K; Simbeza SS; Zulu N; Geng EH; Eshun-Wilsonova I; Le Tourneau N; Pry JM
Defining person-centred treatment support for multidrug-resistant TB: a discrete choice experiment.
(2026-Jun) Kagujje, Mary; Mtumbi G; Sikandangwa M; Shatalimi J; Muyoyeta, Monde; Kerkhoff, Andrew D.
BACKGROUND: Multidrug-resistant TB (MDR-TB) treatment remains challenging, with significant toxicity and associated hardships that undermine adherence and cure rates. Support packages may improve outcomes, but the features most valued by people with MDR-TB are unknown.
METHODS: A discrete choice experiment was performed among adults receiving MDR-TB treatment in Lusaka, Zambia. Five features (3-4 levels each) comprising a support package were evaluated through 12 choice tasks comparing hypothetical packages.
RESULTS: Among 99 participants (median age 36 years, 68.9% men, 42.4% HIV-positive), material support was the most valued feature (relative importance [RI] = 45.7%), with transport vouchers plus food assistance being the most preferred option. Visit frequency was also important (RI = 26.7%), with similar preferences for monthly and bimonthly visits. Participants preferred phone calls for visit reminders (RI = 11.8%), health care workers for emotional support (RI = 11.2%), and community-based health care workers or loved ones for treatment observation (RI = 4.7%). Three distinct preference groups were identified - all highly valued material support but varied in their preferences for other support features and their delivery.
CONCLUSION: Among people with MDR-TB in Zambia, material support mechanisms and less frequent clinic visits were highly valued. Incorporating patient preferences into treatment programmes could optimise MDR-TB care and improve treatment adherence and outcomes.