Centre for Infectious Disease Research in Zambia
Institutional repository for research publications and data.
Communities in CIDRZ Publications
Select a community to browse its collections.
- Browse our collections to access publications on infectious diseases, maternal and child health, epidemiology, and more.
- Access quarterly, semi-annual, and annual internal and external reports from CIDRZ programs and research to support data-informed decision-making and accountability.
Recent Submissions
Availability, cost, and budget impact of lifesaving postpartum hemorrhage interventions in public hospitals in Zambia: A cross-sectional survey.
(2026-Jul) Kapesa H; Manasyan A; Muttau N; Sinkey RG; Gallos I; Tembo T
OBJECTIVE: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality globally. Most PPH deaths are preventable through evidence-based interventions. This study assessed the availability, direct costs, and economic implications of World Health Organization-recommended PPH interventions in public hospitals in Zambia.
METHODS: A cross-sectional survey was conducted in 31 purposively selected public hospitals across seven provinces. Data (June 2019 to May 2020) on PPH prevalence, resource availability, and direct costs of PPH interventions were collected via a structured questionnaire administered to hospital administrators. An ingredients-based costing model compared an ideal pathway (severe PPH managed at a fully equipped primary-level health facility) to a referral pathway (patients unresponsive to early-stage interventions transferred to a tertiary hospital). Data were analyzed using Python.
RESULTS: Among 74 238 deliveries, 1957 (2.6%) were PPH cases, resulting in 94 (4.8%) fatalities. Most cases (86.9%) received medical management, primarily by nurse-midwives. Tranexamic acid (TXA) was available in only 58.1% of the hospitals (subsidized cost: US$1.91/dose). Managing a severe PPH case in the ideal pathway cost US$133.46-US$276.22, compared to US$153.34-US$332.53 via the referral pathway , representing an 18.6% increase. Scaled nationally (approximately 672 000 births), this inefficiency translates to an avoidable annual burden of US$133121.
CONCLUSION: While oxytocin is universally available, access to critical treatments such as TXA and advanced interventions remains limited. The low cost of preventive interventions contrasts with the high cost of managing severe PPH, which is exacerbated by system fragmentation. Strengthening primary-level facilities with essential commodities, surgical capacity, and training is critical to containing costs and reducing maternal mortality due to PPH.
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