Centre for Infectious Disease Research in Zambia
Institutional repository for research publications and data.
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Recent Submissions
Clinically Diagnosed Pulmonary TB and its Association with Mortality in Zambia: A Secondary Data Analysis of a Prospective Diagnostic Cohort
(2026) Dr Mary Kagujje
Among 582 pulmonary TB patients, 293 (50.3%) patients were clinically diagnosed. Previous TB history, age, symptom duration and chest X-ray interpretation were independently associated with clinically diagnosed TB. Clinically diagnosed TB was not associated with an increased mortality rate compared to bacteriologically confirmed TB.
Data_TPT Scale up to ≥5 years old HIV-negative TB contacts
(2026) Dr Phallon B. Mwamba
One Health Baseline Study Report
(Centre for Infectious Disease Research in Zambia (CIDRZ), 2026-12-17) Somwe, Paul; Barry Walsh, Paula; Riblet, Michelle; Butler, David; Lumpa, Mwansa; Sharma, Anjali; Rios, Rafaella; Whelan, Niamh; Chipungu, Jenala; Banda, Humphrey; Mataa, Liywalii
The One Health Baseline Research Study was conducted to assess knowledge, practices, and regulatory frameworks related to food safety, animal health and disease surveillance, and the control of animal medicines in Zambia. The study aimed to inform a just transition toward a sustainable and resilient food system by strengthening One Health interventions that reduce production and consumption shocks and mitigate crisis risks. Using a mixed-methods approach, quantitative and qualitative data were collected from 340 stakeholders, including livestock and crop farmers, food processors, buyers and retailers, and regulators across six districts in Eastern, Lusaka, Northern, and Southern Provinces.
Findings indicate that stakeholders possess a holistic understanding of One Health, recognising the interdependence of food safety, animal health, environmental sustainability, and socio-economic factors. Positive progress was observed, including strong awareness of zoonotic diseases among livestock farmers, high compliance with food business registration requirements, and recognition of inspectors as trusted information sources. However, significant challenges persist, particularly related to limited institutional capacity, regulatory overlaps, inadequate risk management skills, weak oversight of animal medicines, and insufficient infrastructure and training. Misuse of veterinary drugs and pesticides poses risks to public health, animal health, and the environment, contributing to antimicrobial resistance and undermining disease control efforts.
The study highlights the importance of strengthened institutional coordination, improved policy communication, risk-based approaches, and inclusive stakeholder engagement from farm to fork. Digital innovations such as the Zambia Animal Health Information System demonstrate potential for enhancing disease surveillance and evidence-based decision-making. Overall, the findings underscore the need for integrated, risk-based, and community-informed One Health strategies to improve food safety, support sustainable livelihoods, and strengthen Zambia’s agri-food system resilience.
Mixed methods approach to examining the implementation experience of a phone-based survey for a SARS-CoV-2 test-negative case-control study in California.
(2024) Fukui N; Li SS; DeGuzman J; Myers JF; Openshaw J; Sharma A; Watt J; Lewnard JA; Jain S; Andrejko KL; Pry JM
OBJECTIVE: To describe the implementation of a test-negative design case-control study in California during the Coronavirus Disease 2019 (COVID-19) pandemic.
STUDY DESIGN: Test-negative case-control study.
METHODS: Between February 24, 2021 - February 24, 2022, a team of 34 interviewers called 38,470 Californians, enrolling 1,885 that tested positive for SARS-CoV-2 (cases) and 1,871 testing negative for SARS-CoV-2 (controls) for 20-minute telephone survey. We estimated adjusted odds ratios for answering the phone and consenting to participate using mixed effects logistic regression. We used a web-based anonymous survey to compile interviewer experiences.
RESULTS: Cases had 1.29-fold (95% CI: 1.24-1.35) higher adjusted odds of answering the phone and 1.69-fold (1.56-1.83) higher adjusted odds of consenting to participate compared to controls. Calls placed from 4pm to 6pm had the highest adjusted odds of being answered. Some interviewers experienced mental wellness challenges interacting with participants with physical (e.g., food, shelter, etc.) and emotional (e.g., grief counseling) needs, and enduring verbal harassment from individuals called.
CONCLUSIONS: Calls placed during afternoon hours may optimize response rate when enrolling controls to a case-control study during a public health emergency response. Proactive check-ins and continual collection of interviewer experience(s) and may help maintain mental wellbeing of investigation workforce. Remaining adaptive to the dynamic needs of the investigation team is critical to a successful study, especially in emergent public health crises, like that represented by the COVID-19 pandemic.
An exploration of multi-level factors affecting routine linkage to HIV care in Zambia's PEPFAR-supported treatment program in the treat all era.
(2024) Chipungu J; Smith H; Mwamba C; Haambokoma M; Sharma A; Savory T; Musheke M; Pry J; Bolton C; Sikazwe I; Herce ME
Multiple steps from HIV diagnosis to treatment initiation and confirmed engagement with the health system are required for people living with HIV to establish full linkage to care in the modern treat all era. We undertook a qualitative study to gain an in-depth understanding of the impeding and enabling factors at each step of this linkage pathway. In-depth interviews were conducted with fifty-eight people living with HIV recruited from ten routine HIV care settings supported by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) in Lusaka, Zambia. Using a semi-structured interview guide informed by an established conceptual framework for linkage to care, questions explored the reasons behind late, missed, and early linkage into HIV treatment, as well as factors influencing the decision to silently transfer to a different clinic after an HIV diagnosis. We identified previously established and intersecting barriers of internal and external HIV-related stigma, concerns about ART side effects, substance use, uncertainties for the future, and a perceived lack of partner and social support that impeded linkage to care at every step of the linkage pathway. However, we also uncovered newer themes specific to the current test and treat era related to the rapidity of ART initiation and insufficient patient-centered post-test counseling that appeared to exacerbate these well-known barriers, including callous health workers and limited time to process a new HIV diagnosis before treatment. Long travel distance to the clinic where they were diagnosed was the most common reason for silently transferring to another clinic for treatment. On the other hand, individual resilience, quality counseling, patient-centered health workers, and a supportive and empathetic social network mitigated these barriers. These findings highlight potential areas for strengthening linkage to care and addressing early treatment interruption and silent transfer in the test and treat era in Zambia.