Browsing by Author "Phiri G"

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Descriptive analysis of colorectal cancer in Zambia, Southern Africa using the National Cancer Disease Hospital Database.
(2018) Asombang AW; Madsen R; Simuyandi M; Phiri G; Bechtold M; Ibdah JA; Lishimpi K; Banda L; Department of Statistics, University of Missouri-Columbia School of Medicine, Missouri, USA.; Cancer Disease Hospital (CDH), Lusaka, Zambia.; Division of Gastroenterology and Hepatology, University of Missouri-Columbia School of Medicine, Missouri, USA.; Center of Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Division of Gastroenterology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
INTRODUCTION: Colon cancer is preventable. There is a plethora of data regarding epidemiology and screening guidelines, however this data is sparse from the African continent. Objective: we aim to evaluate the trends of colorectal cancer (CRC) in a native African population based on age at diagnosis, gender and stage at diagnosis. METHODS: We conducted a retrospective analysis of the Cancer Disease Hospital (CDH) registry in Zambia, Southern Africa. RESULTS: 377 charts were identified in the CDH registry between 2007 and 2015, of which 234 were included in the final analysis. The mean age at diagnosis was 48.6 years and 62% are males. Using descriptive analysis for patterns: mode of diagnosis was surgical in 195 subjects (84%), histology adenocarcinoma in 225 (96.5%), most common location is rectum 124 (53%) followed by sigmoid 31 (13.4%), and cecum 26 (11%). 122 subjects (54%) were stage 4 at diagnosis. Using the Spearman rank correlation, we see no association between year and stage at diagnosis (p = 0.30) or year and age at diagnosis (p = 0.92). CONCLUSION: Colorectal cancer was diagnosed at a young age and late stage in the Zambian patients.
Feasibility and Effectiveness of a Peer Referral Incentive Intervention to Promote Male Circumcision Uptake in Zambia.
(2016-Aug-15) Zanolini A; Bolton C; Lyabola LL; Phiri G; Samona A; Kaonga A; Thirumurthy H; *Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; †Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; ‡Society for Family Health, Lusaka, Zambia; and §Ministry of Community Development, Mother and Child Health, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
BACKGROUND: Medical male circumcision is a promising HIV prevention tool in countries with generalized HIV epidemics, but demand creation interventions are needed to support scale-up. We piloted a peer referral intervention in which circumcision clients were offered incentives for referring their peers for circumcision. METHODS: The intervention was implemented between June 2014 and February 2015 in 6 randomly selected health facilities in Southern Province, Zambia. For the first 5 months, circumcision clients ≥18 years of age were given referral vouchers that allowed them to refer up to 5 peers for circumcision within a 3-month period. An incentive of US$2 was offered for each referral. The primary outcome was the number of circumcisions performed per month in each facility. To assess the effect of the intervention, a difference-in-difference analysis was performed using longitudinal data from the intervention facilities and 22 nonintervention facilities. A questionnaire was also implemented to understand men's perceptions of the intervention. RESULTS: During the 8-month intervention period, 1222 men over 18 years of age were circumcised in intervention facilities. In the first 5 months, 699 circumcision clients were enrolled and 385 clients brought a referral voucher given to them by an enrolled client. Difference-in-difference analyses did not show a significant increase in circumcisions performed in intervention facilities. However, circumcision clients reported that the referral incentive motivated them to encourage their friends to seek male circumcision. Peer referrals were also reported to be an important factor in men's decisions because 78% of clients who were referred reported that talking with a circumcised friend was important for their decision to get circumcised. CONCLUSIONS: The peer referral incentive intervention for male circumcision was feasible and acceptable. However, the intervention did not have a significant effect on demand for male circumcision. Barriers to circumcision and features of the intervention may have limited the effect of the intervention. Further efforts regarding encouraging male-to-male communication and evaluations with larger sample sizes are needed.