Browsing by Author "Chisunka M"

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    Burden of chronic kidney diseases and underlying causes in Zambia: evidence from the global burden of disease study 2019.
    (2023-Feb-18) Bosomprah S; Bjonstad EC; Musuku J; Siyumbwa N; Ngandu M; Chisunka M; Banda P; Goma F; Mweemba A; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, USA.; Department of Internal Medicine, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia.; Noncommunicable Diseases and Injury Commission, Lusaka, Zambia.; Research Department, Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.; Department of Biostatistics, School of Public Health, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana. sbosomprah@ug.edu.gh.; Ministry of Health, Lusaka, Zambia.; Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia.; Noncommunicable Diseases and Injury Commission, Lusaka, Zambia. sbosomprah@ug.edu.gh.; Research Department, Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia. sbosomprah@ug.edu.gh.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    INTRODUCTION: Chronic kidney disease (CKD) has been a global public health problem and a major source of suffering and poor quality of life for those afflicted. Using data from the global burden of disease (GBD) study 2019, we estimated the magnitude of the burden of CKD as well as the underlying causes of CKD in the Zambian population. METHOD: The data used for this study were extracted from the GBD 2019 study. The GBD 2019 provides estimates of several metrics of disease burden including the commonly used disability-adjusted life year (DALYs) for over 369 diseases and injuries, and 87 risk factors and combinations of these in 204 countries and territories from 1990 to 2019. We estimated the burden of CKD as the number and rates (per 100,000 population) of DALYs, disaggregated by year, sex, and age group. We examined the underlying causes of CKD by estimating the population attributable fraction as the percentage contributions of risk factors to CKD DALY. RESULTS: The number of DALYs for CKD was estimated as 76.03 million (95% UI: 61.01 to 93.36) in 2019 compared to 39.42 million (95% UI: 33.09 to 45.90) in 1990, representing 93% increase whereas the DALYs rate per 100,000 population was estimated as 416.89 (95% UI: 334.53 to 511.93) in 2019 compared to 496.38 (95% UI: 416.55 to 577.87) in 1990, representing 16% reduction. CKD due to hypertension accounted for 18.7% of CKD DALYs and CKD due to diabetes (types 1 and 2) accounted for 22.7%, while CKD from glomerulonephritis accounted for the most DALYs at 33%. The age group most impacted from CKD were adolescents and young adults. CONCLUSION: The burden of CKD remains high in the Zambian population with diabetes, high blood pressure, and glomerulonephritis as important causes. The results highlight the need to develop a comprehensive action plan to prevent and treat kidney disease. Increasing the awareness of CKD among the public as well as adaptation of guidelines for treating patients with end stage kidney disease are important considerations.
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    Facility readiness for decentralized Package of Essential Noncommunicable Disease Interventions-Plus (PEN-Plus) care in nine lower-income countries.
    (2025) Drown L; Adler AJ; Salvi D; Boudreaux C; Gupta N; Ali Z; Bay N; Chisunka M; Mulenga B; Koirala B; Maharjan B; Marro G; Mengistu Z; Mtumbuka E; Nabadda M; Ruckstuhl L; Wurie I; Thapa A; Mocumbi A; Bukhman G; Wroe EB; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.; Department of Global Health and Social Medicine, Program in Global Noncommunicable Disease and Social Change, Harvard Medical School, Boston, Massachusetts, United States of America.; Kathmandu Institute of Child Health, Kathmandu, Nepal.; SolidarMed, Harare, Zimbabwe.; Universidade Eduardo Mondlane, Maputo, Mozambique.; Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda.; Pujehun Hospital, Ministry of Health, Pujehun, Sierra Leone.; Partners In Health, Boston, Massachusetts, United States of America.; Department of Medicine, Center for Integration Science in Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.; Doctors With Africa CUAMM, Padova, Italy.; Mathiwos Wondu-Ye Ethiopia Cancer Society, Addis Ababa, Ethiopia.; Clinton Health Access Initiative, Dar es Salaam, Tanzania.; Noncommunicable Diseases Alliance Kenya, Nairobi, Kenya.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    Severe chronic noncommunicable diseases (SC-NCDs) are important causes of avoidable disease burden in low- and lower-middle income countries (LLMICs) where care is often available only at tertiary, urban facilities. The Package of Essential Noncommunicable Disease Interventions - Plus (PEN-Plus) strategy aims to address gaps in access to care for SC-NCDs by integrating and decentralizing care. This study aims to assess baseline readiness of 16 facilities in nine LLMICs to provide care for SC-NCDs as part of a mixed-methods evaluation of PEN-Plus implementation. Cross-sectional surveys were utilized to collect baseline data from 16 facilities initiating new PEN-Plus programs. These surveys assessed the state of facility infrastructure and the availability of equipment and medicines for three priority conditions (type 1 diabetes (T1D), sickle cell disease (SCD), severe cardiac conditions (SCC)). Analysis consisted of descriptive statistics and summary index scores based on availability of key items. Facilities reported a high baseline availability of basic infrastructure. Readiness to provide care for priority SC-NCDs varied. Availability of functional diagnostic and management equipment and supplies for T1D was especially low in many facilities but higher for SCD. Medicine availability was overall highest for T1D (75%) but lower for SCD (39%) and SCC (49%), with significant gaps in essential medicines including hydroxyurea, anticoagulants, and medium- or long-lasting insulins.These findings highlight the need for tailored, context-driven implementation approaches to address gaps in readiness for SC-NCD care in LLMICs. Baseline results will guide ongoing implementation and evaluation of the PEN-Plus clinics.