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The CIDRZ Research Repository serves as an open-access archive for peer-reviewed publications, conference papers, and other scholarly outputs from CIDRZ researchers. Our goal is to promote the dissemination of knowledge and support evidence-based public health initiatives.
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Item Infectious Disease Management Using Nanoparticles and Histopathological Evaluation(2026-9-8) Bairmani Mohammed Shawket; Aljezani HasanAbstract Not Available Bangladesh Journal of Infectious Diseases, June 2026;13(1):1-2Item <b>Challenges Experienced by Job Seekers During the Qualification Verification Process Conducted by the Zambia Qualifications Authority (ZAQA): Evidence from Ndola District, Zambia</b>(2026-9-2) Chalwe Richard; Mundia MukwalikuliQualification verification is an important component of education and employment systems because it establishes the authenticity, validity and recognition of academic and professional qualifications. In Zambia, the Zambia Qualifications Authority (ZAQA) is responsible for coordinating qualification recognition and verification. However, job seekers may encounter challenges during the verification process that can affect their participation in recruitment processes. This study examined the challenges experienced by job seekers during the qualification verification process conducted by ZAQA in Ndola District, Zambia, assessed how these challenges affect employment opportunities, and identified strategies for improving verification services. The study adopted a mixed-methods research approach using a descriptive research design and a convergent parallel mixed-methods design. Data were collected from 150 participants comprising 145 job seekers who completed structured questionnaires and five ZAQA officials who participated in semi-structured interviews. Quantitative data were analysed using frequencies and percentages, while qualitative data were analysed thematically. The study was guided by Systems Theory. The findings revealed that long processing time was the most frequently reported challenge, accounting for 33.1% of job seekers, followed by high verification fees (21.4%), poor communication and feedback (16.6%), technical challenges with the online system (13.1%), repeated submission of documents (10.3%), and limited accessibility to ZAQA services (5.5%). The challenges affected employment opportunities mainly through delayed recruitment processes (38.6%), missed employment opportunities (23.4%), increased financial burdens (17.9%), reduced motivation to apply for jobs (11.7%), and loss of employer confidence (8.4%). Respondents identified faster processing, improved communication, stronger online verification systems, reduced verification fees, increased staffing and improved institutional collaboration as key strategies for improving the system. The study concludes that qualification verification should be treated as an interconnected service-delivery system involving ZAQA, applicants, educational institutions, technology and employers. Improving coordination among these components is essential for reducing delays and enhancing employment outcomes.Item Large language models for clinical decision support in infectious disease diagnosis and antimicrobial prescribing: a scoping review(2026-9-1) Sannathimmappa Mohan BilikallahalliAbstract Background Antimicrobial resistance is one of the leading threats to global health. The inappropriate use of antibiotics is one of its strongest drivers. Large language models (LLMs) have entered clinical discussion as tools that might support diagnosis and prescribing. However, their specific role in infectious-disease (ID) care has not been mapped in a structured way. This scoping review charts the breadth, applications, performance signals, and limitations of LLMs used for clinical decision support in ID diagnosis and antimicrobial prescribing. Methods We followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched PubMed/MEDLINE for peer-reviewed sources that described LLM-based decision support in ID diagnosis or antimicrobial use. Sources were charted by application domain, model evaluated, study design, reported outcomes, and stated limitations. Findings were summarized descriptively. Inferential statistics are reported only as stated by the primary studies. Results Forty-seven sources were included. They were mapped to five domains: diagnosis and clinical reasoning; antimicrobial prescribing and stewardship; resistance and mechanism prediction; consultation and disease-specific management; and mitigation, evaluation, and ethics. LLMs answered medical-knowledge and case questions at or near passing thresholds. In vignette studies, they achieved diagnostic accuracy comparable to physicians. However, prescribing performance was inconsistent. Agreement with ID specialists on antibiotic choice was often modest, accuracy fell as case complexity rose, and unsafe or guideline-discordant advice recurred. Retrieval-augmented generation and domain grounding consistently improved accuracy and reduced hallucination. Conclusions Current evidence supports an assistive, human-supervised role for LLMs in ID care rather than autonomous prescribing. Standardized evaluation, prospective validation, local grounding, and explicit stewardship oversight are prerequisites for safe adoption. Clinical trial registration Not applicable. This study is a scoping review of existing literature and is not a clinical trial; therefore, no clinical trial registration number is applicable.Item Impact of COVID-19 on neglected tropical diseases in Zambia: a qualitative study of stakeholder perspectives(2026-8-25) Butala Caitlin Brigid; Fyfe Jenna; Machila Noreen; Welburn Susan ChristinaAbstract Background Neglected tropical diseases (NTDs) remain a major public health challenge in Zambia and other low‑ and middle‑income countries, and there is concern that the COVID‑19 pandemic has further disrupted progress towards control and elimination targets. This study explored how COVID‑19 affected NTD programmes, funding, and partnerships in Zambia from the perspective of national‑level stakeholders. Methods We conducted a qualitative case study using semi‑structured interviews with key informants involved in NTD policy, programming, or surveillance in Zambia. Fourteen participants were purposively sampled from government ministries, the Zambia National Public Health Institute, international organisations, and academia. Interviews were conducted in person, audio‑recorded, transcribed verbatim, and anonymised. Data were analysed using inductive thematic analysis, with codes developed from the transcripts and iteratively grouped into themes through constant comparison. Results Five overarching themes were identified: (1) public health infrastructure; (2) disease prioritisation and surveillance; (3) resource allocation and funding challenges; (4) collaboration and partnerships; and (5) direct impacts of COVID‑19 on NTD activities. Participants reported that COVID‑19 exposed and intensified pre‑existing weaknesses in health system capacity, routine NTD surveillance, and financing, contributing to delays and reduced coverage of mass drug administration (MDA) and other interventions. Donor funding reallocation and the withdrawal or scaling back of some international partners created further uncertainty for NTD programmes, although various national institutions and the World Health Organization (WHO) helped sustain essential activities. At the same time, the pandemic period coincided with the strengthening of the Zambia National Public Health Institute and the development of updated NTD and One Health strategic plans. Stakeholders viewed these institutional changes as opportunities to build a more resilient NTD response. Conclusions COVID‑19 disrupted NTD programmes in Zambia primarily by amplifying long‑standing structural vulnerabilities in funding, surveillance, and service delivery, rather than through complete programme collapse. Strengthening routine NTD data systems, securing more predictable domestic financing, operationalising One Health and NTD master plans, and building more resilient, locally owned partnerships will be essential to recover lost ground and protect NTD control efforts from future shocks.Item Heterogeneity of use, access, and retention of insecticide-treated nets: Implications for subnational tailoring to maximise malaria control(2026-8-20) Glover Andrew C; Koenker Hannah; Niang El Hadji Amadou; Kolaczinski Kate; Churcher Thomas SBackground: While insecticide-treated nets (ITNs) are highly impactful and cost-effective for malaria control, they are primarily distributed through three-yearly mass campaigns yet are typically retained for shorter periods. It is unclear whether disease control could be best improved with more efficacious ITNs and/or increased distribution frequency. There are increased calls to optimise resources through subnational tailoring of interventions, though benefits will depend on how long people use ITNs and how this varies between regions; yet this has not been previously quantified subnationally. Methods: We estimated subnational differences in ITN use, access, and retention for six countries (Burkina Faso, Ghana, Malawi, Mali, Mozambique, and Senegal) and used these to calibrate a Plasmodium falciparum transmission dynamics model, generating subnational case estimates under different distribution strategies. Results: On average, people used their ITNs for 21 months though this varied subnationally from 12 to 38 months. Shifting from triennial to biennial campaigns is projected to increase mean use across all regions from 45.4% to 53.9% and avert substantial additional cases in moderate and high transmission settings. Projected case increases following campaign deprioritisation or switching to less efficacious ITN classes are strongly associated with transmission intensity. Conclusions: Although transmission intensity remains important for subnational tailoring, other factors, such as ITN use given access, meaningfully influence optimal deployment strategies. The framework highlights how routinely collected data can aid policymakers in tailoring disease control programmes at subnational levels. Funding: The work was funded by the Global Fund under the Net Transition Initiative. ACG and TSC acknowledge funding from the MRC Centre for Global Infectious Disease Analysis (MR/R015600/1), jointly funded by the MRC and the UK Foreign, Commonwealth and Development Office (FCDO) under the MRC/FCDO Concordat agreement, and part of the EDCTP2 programme supported by the European Union.Item Heterogeneity of use, access, and retention of insecticide-treated nets: Implications for subnational tailoring to maximise malaria control(2026-8-20) Glover Andrew C; Koenker Hannah; Niang El Hadji Amadou; Kolaczinski Kate; Churcher Thomas SBackground: While insecticide-treated nets (ITNs) are highly impactful and cost-effective for malaria control, they are primarily distributed through three-yearly mass campaigns yet are typically retained for shorter periods. It is unclear whether disease control could be best improved with more efficacious ITNs and/or increased distribution frequency. There are increased calls to optimise resources through subnational tailoring of interventions, though benefits will depend on how long people use ITNs and how this varies between regions; yet this has not been previously quantified subnationally. Methods: We estimated subnational differences in ITN use, access, and retention for six countries (Burkina Faso, Ghana, Malawi, Mali, Mozambique, and Senegal) and used these to calibrate a Plasmodium falciparum transmission dynamics model, generating subnational case estimates under different distribution strategies. Results: On average, people used their ITNs for 21 months though this varied subnationally from 12 to 38 months. Shifting from triennial to biennial campaigns is projected to increase mean use across all regions from 45.4% to 53.9% and avert substantial additional cases in moderate and high transmission settings. Projected case increases following campaign deprioritisation or switching to less efficacious ITN classes are strongly associated with transmission intensity. Conclusions: Although transmission intensity remains important for subnational tailoring, other factors, such as ITN use given access, meaningfully influence optimal deployment strategies. The framework highlights how routinely collected data can aid policymakers in tailoring disease control programmes at subnational levels. Funding: The work was funded by the Global Fund under the Net Transition Initiative. ACG and TSC acknowledge funding from the MRC Centre for Global Infectious Disease Analysis (MR/R015600/1), jointly funded by the MRC and the UK Foreign, Commonwealth and Development Office (FCDO) under the MRC/FCDO Concordat agreement, and part of the EDCTP2 programme supported by the European Union.Item Present or absent: risks and protective factors of sudden infant death syndrome (SIDS) in the Zambian context.(2026-Aug-07) Zulu E; Mwananyanda L; Pieciak R; Forman L; Shah J; Gill CJ; Chilengi R; Payne-Lohman B; Duffy C; Osei-Poku G; Thea D; Somwe SW; Herlihy JMBACKGROUND: Despite a reduction in sudden unexplained infant death (SUID) in high-income countries, the incidence of SUID and the prevalence of its risk and protective factors remain poorly understood in Zambia due to limited research. We aimed to describe the infant sleep positions and sleep environments in an urban Zambian population to gain a better understanding of modifiable risk factors for SUID. METHODS: We used antenatal, birth, and postnatal data from the Zambian Infant Cohort Study, a prospective birth cohort, to describe infant sleep practices in Chawama, a densely populated peri-urban community in Lusaka, Zambia. In addition to the longitudinal cohort data, we collected cross-sectional data on infant sleep practices and environmental risk factors associated with SUID during the 20-week study visit using a structured questionnaire. RESULTS: We collected data from 596 caregivers and 605 infants. Overall, sudden infant death syndrome accounted for 8.3% (n/N = 3/36) of deceased infants. However, given the limited number of cases, this estimate should be interpreted with caution. Only 6.4% of caregivers attained an education beyond secondary school, and a significant proportion of infants (20.2%) had low birth weights, with 10.7% of infants confirmed by ultrasound as preterm. Furthermore, 96.5% of infants were placed to sleep on their side or in a prone position, and 98.2% of infants shared a sleep surface with their caregiver. Breastfeeding, a protective factor, reduced from 99.2% on day six to 43.1 at the 24-week visit. CONCLUSIONS: Both modifiable (bed-sharing and prone sleep position) and non-modifiable risk factors (low birthweight and prematurity) of SUID are prevalent in this low socioeconomic setting in Zambia. Public health strategies to prevent SUID need to be innovative and culturally congruent in addressing modifiable risks in settings where there is a lack of space.Item Artificial Intelligence in Infectious Disease Research(2026-8-4) Bharathi Kanniganti; Yadav Jeetendra; Shastri Siddhant; Deo Vishal; Shalini Sneh; Yadav Rohit; Chauhan Arohi; Pati SanghamitraItem Salmonella uses sulfate reductases with unique catalytic activity to promote gut colonization in mice(2026-8-5) Kim Ju-Sim; Uppalapati Siva; Margolis Alyssa; McClelland Michael; Elajaili Hanan; Nozik Eva; Liu Lin; Vazquez-Torres AndresAbstract Non-typhoidal Salmonella use molybdenum cofactor-containing MopB- or DMSO reductase-family members to respire chemically diverse substrates, including formate, nitrate and methionine sulfoxide, during infection. The DmsABC enzymatic complex encodes one such DMSO reductase to promote oxidative stress resistance. The Salmonella genome encodes several gene paralogues but their role in virulence is unclear. Here we characterize three Salmonella MopB-family extracytoplasmic sulfate reductases, which we call Xsr1A, Xsr2A and Xsr3A. Infection experiments in mice and macrophages show that these sulfate reductases support Salmonella growth and virulence in the gut and during systemic infection, countering the oxidative effects of host respiratory burst activity. Further experiments show that they are molybdenum cofactor-independent enzymes, and instead depend on the nearby redox-active [4Fe–4S] prosthetic group for catalytic activity. Orthologues of these sulfate reductases were found across distant evolutionary branches, suggesting that [4Fe–4S]-dependent catalysis may occur across the ubiquitous MopB superfamily. Our findings offer insights into the modular evolution of redox centres in the widespread MopB superfamily.Item Building Committed Teachers Through Authentic Leadership: Evidence and Implications for Educational Policy, Western Province, Zambia(2026-8-6) Ephraim Mulambwa Kamizhi; Clement MwaangaTeacher retention, commitment, and organizational effectiveness represent intersecting policy challenges facing Zambia’s educational systems. This mixed-methods study, drawing on Authentic Leadership Theory and Social Exchange Theory, examines authentic principal leadership as a mechanism for building teacher affective commitment and enhancing school organizational effectiveness. Quantitative data from 402 teachers across five districts were analyzed using Structural Equation Modelling; qualitative data from 20 Headteachers were analyzed thematically. The SEM demonstrated that authentic leadership exerts an exceptionally strong effect on affective commitment (β = 0.963, p < .001) and, through this commitment, significantly drives organizational effectiveness (indirect β = 0.364; 95% CI [0.285, 0.448]), accounting for 46% of the total leadership-effectiveness relationship. Contrary to prevailing policy assumptions grounded in Herzberg and Locke, job satisfaction did not independently predict organizational effectiveness (β = 0.009, p = .825) when modelled alongside authentic leadership and affective commitment. Qualitative findings revealed four barriers to authentic leadership: cultural paternalism rooted in Lozi leadership traditions, resource constraints, systemic policy incoherence, and a mis-specified accountability framework that prioritises examination results over relational conditions. The paper proposes the CARE Policy Framework (Culturally Adaptive, Relationally Authentic, Effectiveness-Broadened) for principal leadership development and school accountability reform in Zambia.