Cole S.M.,University of Arizona |
Tembo G.,University of Zambia
Social Science and Medicine | Year: 2011
A growing number of studies show support for a positive association between food insecurity and poor mental health in developing countries. Few of these studies, however, explore the relationship statistically employing longitudinal data. This study combines ethnography with randomly sampled household-level panel data (two waves) collected in 2009 to examine the association between food insecurity and mental health in rural Zambia. Mental health was measured using the Self-Reporting Questionnaire and food insecurity was assessed utilizing a modified 7-item scale based on local coping strategies used during food shortages. A multilevel linear regression model was employed with repeated measures nested within individuals (N = 280 observations) living in 81 households nested within 16 villages. Regression results confirm the postulated positive association between poor mental health and food insecurity. Food insecurity during the dry season, the time of year in rural Zambia when many households are typically food secure, had a subsequent greater effect on mental health than food insecurity during the rainy season. The difference in the effect was statistically significant at the five-percent level. In a country where mental health care resources are severely lacking, policy and applied efforts aimed at improving access to key agricultural resources, thereby increasing agricultural output, could potentially produce beneficial mental health outcomes. © 2011 Elsevier Ltd.
Fink G.,Harvard University |
Masiye F.,University of Zambia
Journal of Health Economics | Year: 2015
We evaluate the productivity effects of investment in preventive health technology through a randomized controlled trial in rural Zambia. In the experiment, access to subsidized bed nets was randomly assigned at the community level; 516 farmers were followed over a one-year farming period. We find large positive effects of preventative health investment on productivity: among farmers provided with access to free nets, harvest value increased by US$ 76, corresponding to about 14.7% of the average output value. While only limited information was collected on farming inputs, shifts in the extensive and the intensive margins of labor supply appear to be the most likely mechanism underlying the productivity improvements observed. © 2015 Elsevier B.V.
Lawn S.D.,University of Cape Town |
Lawn S.D.,London School of Hygiene and Tropical Medicine |
Zumla A.I.,University College London |
Zumla A.I.,University of Zambia
The Lancet | Year: 2011
Tuberculosis results in an estimated 1·7 million deaths each year and the worldwide number of new cases (more than 9 million) is higher than at any other time in history. 22 low-income and middle-income countries account for more than 80 of the active cases in the world. Due to the devastating effect of HIV on susceptibility to tuberculosis, sub-Saharan Africa has been disproportionately affected and accounts for four of every five cases of HIV-associated tuberculosis. In many regions highly endemic for tuberculosis, diagnosis continues to rely on century-old sputum microscopy; there is no vaccine with adequate effectiveness and tuberculosis treatment regimens are protracted and have a risk of toxic effects. Increasing rates of drug-resistant tuberculosis in eastern Europe, Asia, and sub-Saharan Africa now threaten to undermine the gains made by worldwide tuberculosis control programmes. Moreover, our fundamental understanding of the pathogenesis of this disease is inadequate. However, increased investment has allowed basic science and translational and applied research to produce new data, leading to promising progress in the development of improved tuberculosis diagnostics, biomarkers of disease activity, drugs, and vaccines. The growing scientific momentum must be accompanied by much greater investment and political commitment to meet this huge persisting challenge to public health. Our Seminar presents current perspectives on the scale of the epidemic, the pathogen and the host response, present and emerging methods for disease control (including diagnostics, drugs, biomarkers, and vaccines), and the ongoing challenge of tuberculosis control in adults in the 21st century. © 2011 Elsevier Ltd.
Kayamba V.,University of Zambia
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde | Year: 2013
Gastric cancer is a leading cause of cancer deaths worldwide but there are few data from Africa. We recently observed a trend towards diagnosis in younger patients. To test the hypothesis that HIV might have altered risk factors for acquisition of gastric cancer, in a case-control study in the University Teaching Hospital, Lusaka, Zambia. Patients (n=52) with confirmed gastric adenocarcinoma and controls (n=94) undergoing endoscopy but with no macroscopic gastric pathology. Established risk factors and HIV status were compared. HIV status did not differ significantly between cases and controls (odds ratio 1.03; 95% CI 0.2 - 4.3; p=1.00) and seroprevalence in cases was similar to that of the Zambian population. Smoking, regular alcohol intake, and gastric atrophy were all associated with cancer in univariate and multivariate analysis. Helicobacter pylori serology was positive in 84% of patients studied and cagA serology in 66%; neither serological marker was associated with cancer. Atrophy was common in cases (57%) and controls (30%) and associated with both smoking and alcohol use. Intestinal metaplasia was present in 17% of the controls, but was not associated with atrophy. HIV was not associated with gastric cancer and does not explain the apparent younger age distribution. Atrophy was common and was not essential for the development of intestinal metaplasia, suggesting that gastric carcinogenesis in Africa does not always follow the pathway from atrophy to intestinal metaplasia to gastric carcinoma (the so-called Correa pathway).
Serpell R.,University of Zambia
Child Development Perspectives | Year: 2011
Abstract- This article examines the implications that 4 decades of multimethod research in Zambia have for psychological assessment, parent-teacher communication, educational policy, and research methodology. Its primary focus is a cultural study of indigenous ideas in a rural Chewa community in eastern Zambia that concluded that, within this culture, children's intelligence was construed as an amalgam of cognitive alacrity and social responsibility. But in Zambia, as elsewhere, the curriculum of institutionalized public basic schooling is almost exclusively addressed to the cultivation of knowledge and cognitive skills. The article outlines the approach to education taken by Child-to-Child, one that resonates with indigenous African values and practices. It also describes a case study of the application of this approach at a public primary school in northern Zambia that documented sustained increases in social responsibility alongside strong academic outcomes. Connections with research and policy in other societies are also discussed. © 2011 The Author. Child Development Perspectives © 2011 The Society for Research in Child Development.