Browsing by Author "Nkwemu C"

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    Outcomes of children aged 2-59 months with chest indrawing pneumonia managed on an outpatient basis in selected primary health facilities in Zambia.
    (2025-Jul-11) Jacobs C; Nkwemu C; Ngambi BB; Silavwe V; Qazi SA; Nisar YB
    BACKGROUND: Zambia has a high burden of child pneumonia, with approximately 6000 children under five dying annually from this condition. We aimed to gather evidence about the outcomes two weeks after enrolment for children 2-59 months with chest indrawing pneumonia who were managed in primary health care facilities in Zambia. METHODS: This was a prospective cohort study conducted between October 2022 and April 2024 in eight primary health care facilities from Lusaka, Chibombo, and Chongwe districts. Children aged 2-59 months with cough and/or breathing difficulty and lower chest indrawing were enrolled, treated on an outpatient basis according to the Integrated Management of Childhood Illness (IMCI) protocol, and followed up on day 15 after enrolment. RESULTS: We enrolled 335 children in the study (median age of 17 months, 56.4% female). Among them, 63% were aged 12-59 months, 23.6% had a height-for-age z-score of<-3.0, and 10.5% had a weight-for-age z-score of<-3.0. By day 15, 314 children had follow-up data, all of whom survived. Of these, 77.1% were cured, 22.9% were reported as being 'clinically better', and none failed therapy. Most children were treated with oral amoxicillin (84.1%), with a cure rate of 82.2%. Children treated with cotrimoxazole (60% cure rate) and erythromycin (26.7% cure rate) had lower success rates. A higher proportion of girls (81.4%) were cured compared to boys (71.5%), and children who were fully vaccinated (79.6%) had a higher cure rate than those who were partially or not vaccinated (48.0%). Children of educated parents had higher cure rates than those of uneducated parents. CONCLUSIONS: Children with chest indrawing pneumonia were successfully treated with oral amoxicillin in an outpatient setting, improving access to treatment and reducing costs for both health care systems and families. This approach also helps reduce the risk of healthcare-associated infections. It is essential that health care providers in primary health facilities are trained to use IMCI protocols when managing children under five.
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    Spatial variations and predictors of neonatal mortality among births to HIV-infected and non-infected mothers in rural Zambia.
    (2025) Shumba S; Tembo D; Simwaka M; Musonda NC; Nkwemu C; Mayimbo S
    In Zambia, neonatal mortality still remains a noteworthy public health problem with a current rate of 27 deaths per 1000 and ranking 162 out of 195 countries globally. The study aimed to investigate the spatial variations and predictors of neonatal mortality in rural Zambia among HIV-infected and non-infected mothers using the national-level data from the 2018 Zambia Demographic and Health Survey (ZDHS). Statistical analyses were conducted using the Rao - Scott Chi-square test to assess associations between neonatal mortality and categorical variables. Additionally, a multilevel mixed effect logistic regression model was used to examine predictors of neonatal mortality. Geospatial variations of neonatal mortality across Zambia's ten provinces were mapped using Quantum Geographical Information System (QGIS) version 3.34.1. Data analysis was performed using R and Stata version 14.2. This study examined the spatial variations and predictors of neonatal mortality among HIV-infected and non-infected mothers in rural Zambia using the 2018 Zambia Demographic Health Survey dataset. Key findings include the protective role of maternal education, with those having secondary or higher education showing reduced odds of neonatal mortality. Women aged 20-24 years in the study had higher odds of neonatal death compared to younger mothers, while delivering in public health facilities was associated with increased neonatal mortality. Maternal HIV status had no significant impact on neonatal outcomes. Spatial analysis revealed significant regional disparities, with high mortality rates in Central, Southern, and Eastern provinces, while North Western Province had lower rates. These results emphasize the need for improved healthcare quality, targeted maternal education programs, and region-specific interventions to address neonatal mortality in Zambia.