Browsing by Author "Sinyange Nyambe"

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Evaluation of measles and acute flaccid paralysis surveillance systems in Southern Province, Zambia, 2022 - 2024
(2026-7-31) Luhanga Herbert Robert Mark; Mwenya Francis Ngosa; Phiri Andrew; Simuzingili Patricia; Habeenzu Cheepa; Zulu James Exnobert; Sakala Jacob; Banda Dabwitso; Sinyange Nyambe
Abstract Background: The Vaccine-Preventable Disease (VPD) surveillance system in Zambia integrates routine immunization monitoring with disease surveillance to guide control measures. In 2022, Zambia recorded 422 measles cases and 37 deaths, with Southern Province recording the highest case fatality rate (11.2%), suggesting possible weaknesses in surveillance performance and outbreak response systems. This evaluation assessed the measles and acute flaccid paralysis (AFP) surveillance systems in Southern province of Zambia from 2022 to 2024. Methods: We conducted a cross-sectional surveillance system evaluation following the Centers for Disease Control and Prevention (CDC) guidelines. We purposively selected three districts and three facilities from each district, based on measles and AFP case burden and vaccination coverage. We collected data on system’s simplicity, usefulness, and acceptability from 27 participants using structured questionnaires. We also collected data from the electronic Integrated Disease Surveillance and Response (eIDSR) system and World Health Organization databases to assess, data completeness, timeliness, and accuracy. Results were summarized using frequencies and percentages. Results: The measles and AFP surveillance systems comprised both passive and active surveillance operating across community, health facility, district, and provincial levels. The systems demonstrated high levels of simplicity (mean score: 84.6%), usefulness (90.5%), and acceptability (90.8%). However, surveillance performance was limited by suboptimal data quality, with mean completeness of 66.7%, timeliness of 51.1%, and data accuracy of 50%. We also identified key operational challenges of inadequate specimen transportation and insufficient program funding. Conclusion: The measles and AFP surveillance systems in Southern Province are functional, simple, acceptable, and well-integrated into routine services. However, significant gaps in data quality limit their effectiveness for early outbreak detection and timely public health response. Strengthening data management, specimen transport, and sustainable program financing will be critical to improving surveillance performance and accelerating progress toward vaccine-preventable disease control and elimination targets. Keywords: Acute Flaccid Paralysis (AFP), measles, surveillance systems, vaccine-preventable disease, Zambia.
Investigation of a Scabies Outbreak at Sandwe Primary School, Lusangazi District, Zambia, 2022
(2026-5-5) Mulambya Jairos; Nzila Oscar; Sinyange Nyambe; Namakando Nosiku; Zulu James; Hamukale Amos; Mwakanadi George; Langa Nelia
Scabies is a neglected tropical disease caused by Sarcoptes scabiei var. hominis and remains a significant concern in overcrowded, resource-limited settings. On 30 March 2022, Sandwe Rural Health Centre reported an unusual cluster of suspected scabies cases among learners at Sandwe Primary School in Lusangazi District. An investigation was conducted to determine the magnitude of the outbreak, describe its epidemiological characteristics, and identify contributors to transmission and institute control measures. The investigation took place between 30 March and 5 April 2022 and used a descriptive approach. A case was defined as any learner presenting with an intensely pruritic rash at one or more typical anatomical sites, with or without visible burrows, or with a positive skin scraping during the outbreak period. Data collection methods included outpatient register reviews, clinical examinations, active case finding, skin scraping for laboratory confirmation, and environmental assessment of the school premises. Twenty-six cases were identified, representing an attack rate of 4.5 percent. The majority of cases were male adolescents, and boarders were disproportionately affected. Six of eleven skin scrapings tested positive for Sarcoptes scabiei ova. Environmental assessment revealed overcrowding, shared sleeping arrangements, shared bathing materials, insufficient ventilation, and inadequate hygiene practices. The outbreak was confirmed to be propagated, driven by overcrowding and poor hygiene conditions. Interventions included mass treatment, improved hygiene education, and surveillance strengthening. Sustainable prevention will require structural improvements to boarding facilities, reductions in crowding, and improved access to essential hygiene materials.
Investigation of Anthrax Outbreak in Wildlife of Mosi-oa-Tunya National Park and Adjacent Communities-Livingstone District, Zambia, October-November 2025
(2026-5-5) Sichalwe Mathews; Banda Humphrey; Bwalya Gregory; Maata Liywalii; Bowa Benson; Hazyondo Mwendalubi; Musalo Brian; Chibale Conrad; Mulopa Paul; Banda Dabwitso; Sinyange Nyambe
INTRODUCTION: Anthrax is an acute zoonotic disease caused by Bacillus anthracis primarily affecting herbivores, but also carnivores and humans through contaminated meat or environments. On 30 October 2025, a dead hippopotamus from Mosi-oa-Tunya National Park was fed to 36 captive lions, causing morbidities and mortalities prompting an outbreak investigation. The objectives included confirming the outbreak, assessing timeliness of detection, notification, and response, mapping wildlife cases, and evaluating knowledge and practices among at-risk populations. METHODS: A descriptive case series investigation was conducted from 16-20 November 2025, and characterized the outbreak by time, place, and host (animal/person). Tissue, soil, and water samples were collected and cultured for B. anthracis isolation. Timeliness was assessed using the 7-1-7 metrics, health record reviews, and key informant interviews. Wildlife case distribution was mapped using Quantum Geographic Information System (QGIS 3.44.7). A structured questionnaire was used to assess knowledge and practices, with ≥60% score on Bloom’s taxonomy scale regarded as adequate. Data was cleaned and analyzed in Microsoft Excel and STATA-17. RESULTS: The anthrax outbreak was confirmed from three animal tissue samples, with one epidemiologically linked human case identified. The outbreak detection occurred 7 days after emergence. Notification was done 6 days after detection while public health responses were initiated 10 days post- notification.16 wildlife cases were identified and a spot map generated. The case fatality rate (CFR) in captive lions was 43.9% (3/7). Among the 25 respondents (80% male; 60% <40 years; 40% livestock farmers, 60% wildlife facility workers), knowledge about anthrax was high with 76%, (19/25) having heard of the disease, 72% (18/25) and 64% (16/25) knew it affects wildlife and livestock respectively. 60% (15/25) were aware of human infection and vaccination as means of livestock protection. However, only 28% (7/25) practiced safe carcass disposal, and 48% (12/25) reported handling or consuming potentially contaminated meat. CONCLUSION: The outbreak was characterized by delayed notification and response. High-risk community practices were also observed. We recommend launching a multisectoral, coordinated and targeted sensitization and community engagement for safe carcass disposal to prevent meat-borne exposure.