Browsing by Author "Menon JA"

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    Strengthening Kangaroo Mother Care at a tertiary level hospital in Zambia: A prospective descriptive study.
    (2022) Muttau N; Mwendafilumba M; Lewis B; Kasprzyk K; Travers C; Menon JA; Mutesu-Kapembwa K; Mangangu A; Kapesa H; Manasyan A; The Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America.; Department of Reproductive, Maternal, Newborn, and Child Health, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Psychology, University of Zambia, Lusaka, Zambia.; Department of Neonatology, Women and Newborn Hospital, University Teaching Hospital, Lusaka, Zambia.; Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: Globally, complications due to preterm birth are the leading contributor to neonatal mortality, resulting in an estimated one million deaths annually. Kangaroo Mother Care (KMC) has been endorsed by the World Health Organisation as a low cost, safe, and effective intervention in reducing morbidity and mortality among preterm infants. The objective of this study was to describe the implementation of a KMC model among preterm infants and its impact on neonatal outcomes at a tertiary level hospital in Lusaka, Zambia. METHODS: We conducted a prospective descriptive study using data collected from the KMC room at the University Teaching Hospital between January 2016 and September 2017. Mothers and government nurses were trained in KMC. We monitored skin-to-skin and breastfeeding practices, weight at admission, discharge, and length of admission. RESULTS: We enrolled 573 neonates into the study. Thirteen extremely low weight infants admitted to the KMC room had graduated to Group A (1,000g-1,499g) at discharge, with a median weight gain of 500g. Of the 419 very low weight neonates at admission, 290 remained in Group A while 129 improved to Group B (1,500g-2,499g), with a median weight gain of 280g. Among the 89 low weight neonates, 1 regressed to Group A, 77 remained in Group B, and 11 improved to Group C (≥2,500g), individually gaining a median of 100g. Of the seven normal weight neonates, 6 remained in Group C individually gaining a median of 100g, and 1 regressed to Group B. Among all infants enrolled, two (0.35%) died in the KMC room. CONCLUSIONS: Based on the RE-AIM metrics, our results show that KMC is a feasible intervention that can improve neonatal outcomes among preterm infants in Zambia. The study findings show a promising, practical approach to scaling up KMC in Zambia. TRIAL REGISTRATION: The trial is registered under ClinicalTrials.gov under the following ID number: NCT03923023.
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    The Impacts of Stigma Against Sexual Minority Men Within and Between Various Socioecological Levels: Breaking the Vicious Cycle in Zambia.
    (2023) Qiao S; Garrett CM; Addo PNO; Adeagbo O; Moore DM; Muttau N; Sharma A; Lwatula C; Ngosa L; Kabwe M; Manasyan A; Menon JA; Weissman S; Li X; Harper GW; School of Public Health, University of Michigan, Ann Arbor, MI, USA.; Department of Epidemiology, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.; The Lotus Identity (TLI), Lusaka, Zambia.; University of Zambia, Lusaka, Zambia.; Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA.; Department of Internal Medicine, School of Medicine Columbia, University of South Carolina, Columbia, SC, USA.; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.; Dignitate Zambia Limited (DZL), Lusaka, Zambia.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.; Department of Global Health, University of Washington, Seattle, WA, USA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    Sexual minority men (SMM) face persistent stigma in Zambia. From a holistic perspective, we aim to explore its impacts within and between multiple socioecological levels, demonstrating how their interactions create a vicious cycle of barriers to the well-being of SMM. In-depth interviews were conducted with 20 purposively recruited SMM from Lusaka, Zambia. All interviews were audio-recorded, after written consent, transcribed verbatim, and iteratively coded employing inductive (i.e., data-driven) approaches for thematic analysis using NVivo. Results suggest three key themes: (1) interpersonal socially perpetuated sexual minority stigma (SMS); (2) multidirectional interactions between psychosocial well-being and risk-taking behaviors; and (3) institutionally perpetuated SMS as a barrier to seeking and receiving health care. SMS permeates across all levels of the socioecological model to negatively impact the psychosocial well-being of SMM while acting also as a barrier to accessing HIV prevention and care. Our study necessitates structural public health intervention to decrease stigma and discrimination against SMM in Zambia, in efforts to increase their psychosocial well-being as well as their access to and utilization of HIV care by breaking the vicious cycle of SMS that pervades through the intrapersonal, interpersonal, and institutional levels of the socioecological model.